ESPE Abstracts (2021) 94 FC8.4

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.

Volume 94

59th Annual ESPE (ESPE 2021 Online)

Online,
22 Sep 2021 - 26 Sep 2021

European Society for Paediatric Endocrinology 

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