ESPE2021 Free Communications Neuroendocrinology (6 abstracts)
Cerebral infarction in childhood-onset craniopharyngioma patients: results of KRANIOPHARYNGEOM 2007
Svenja Boekhoff 1 , Brigitte Bison 2 , Daniela Genzel 2 , Maria Eveslage 3 , Anna Otte 1 , Carsten Friedrich 1 , Jörg Flitsch 4 & Hermann L. Müller 1
1Department of Pediatrics, University Children’s Hospital, Klinikum Oldenburg, Oldenburg, Germany.;2Department of Neuroradiology, University Hospital, Würzburg, Germany.;3Institute of Biostatistics and Clinical Research, University of Münster, Münster, Germany.;4Department of Neurosurgery, University Hospital UKE, Hamburg, Germany
Background: Cerebral infarction (CI) is a known vascular complication following treatment of suprasellar tumors. Risk factors for CI, incidence rate, and long-term prognosis are unknown for patients with childhood-onset craniopharyngioma (CP).
Methods: MRI of 244 CP patients, recruited between 2007 and 2019 in KRANIOPHARYNGEOM 2007, were reviewed for CI. Risk factors for CI and outcome after CI were analyzed.
Results: Twenty-eight of 244 patients (11%) presented with CI based on reference assessment of MRI. One CI occurred before initial surgery and one case of CI after release of intracystic pressure by a cyst catheter. 26 of 28 CI were detected after surgical tumor resection at a median postoperative interval of one day (range: 0.5-53 days). Vascular lesions during surgical procedures were documented in 7 cases with CI. There was a trend (P = 0.094) towards higher initial presurgical tumor volume in CI patients compared with non-CI patients. No relevant differences with regard to surgical approaches were found. In all 12 irradiated patients, CI occurred before irradiation. Multivariable analyses showed that hydrocephalus and gross-total resection at the time of primary diagnosis/surgery both were risk factors for CI. PFS was lower after CI (median survival=1.16 years) when compared with the subgroup of patients without CI (median survival>5.62 years). After CI, quality of life (PEDQOL) and functional capacity (FMH) were impaired.
Conclusions: CI occurs in 11% of CP cases. Tumor size, degree of resection and increased intracranial pressure are risk factors, which should be considered in the planning of surgical procedures for prevention of CI.
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