Umeda Tsuyoshi, Otani Yoshihiro, Fujii Kentaro, Ishida Joji, Hirano Shuichiro, Suruga Yasuki, Kemmotsu Naoya, Imoto Ryoji, Kegoya Yasuhito, Mizuta Ryo, Inoue Yohei, Hokama Madoka, Makihara Seiichiro, Hasegawa Kosei, Inagaki Kenichi, Otsuka Fumio, Yasuhara Takao, Tanaka Shota
Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan.
Department of Otolaryngology-Head and Neck Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama, 700-8558, Japan.
J Neurooncol. 2025 Apr;172(2):471-479. doi: 10.1007/s11060-024-04925-7. Epub 2025 Jan 22.
Craniopharyngiomas are histologically benign tumors, but their proximity to vital neurovascular structures can significantly deteriorate functional prognoses and severely restrict patients' social interaction and activity. We retrospectively identified risk factors related to the functional prognoses in patients with craniopharyngioma treated at our center.
A retrospective analysis was conducted on 40 patients who underwent surgery for craniopharyngioma and follow-up at our institution between 2003 and 2022. Functional prognoses were evaluated in terms of obesity (body mass index [BMI] ≥ 25 for adults, BMI-Z ≥ 1.65 for children), visual function, endocrine function, and social participation. We investigated whether patient characteristics, tumor size, tumor location, hypothalamic involvement, surgical hypothalamic damage, extent of resection, and recurrence rate correlated with these functional prognostic factors.
The median age at diagnosis was 28.0 years, with a median follow-up of 80.5 months. Postoperative obesity was present in 22 patients, and those with postoperative obesity had a significantly higher preoperative BMI or BMI-Z (preoperative BMI for adults: p = 0.074; preoperative BMI-Z for children: p = 0.020) and were significantly correlated with preoperative hypothalamic involvement grade 2 (p = 0.012) and surgical hypothalamic damage grade II (p = 0.0001). Deterioration in social participation was significantly associated with a larger tumor size (p = 0.023) and tumor recurrence (p = 0.0047).
Patients with higher preoperative BMI or BMI-Z and hypothalamic involvement have a greater risk of postoperative obesity, and larger tumor size and recurrence can significantly deteriorate the rate of patients' social participation.
颅咽管瘤在组织学上是良性肿瘤，但其与重要神经血管结构相邻可显著恶化功能预后，并严重限制患者的社交互动和活动。我们回顾性地确定了在本中心接受治疗的颅咽管瘤患者中与功能预后相关的危险因素。
对2003年至2022年期间在本机构接受颅咽管瘤手术及随访的40例患者进行回顾性分析。从肥胖（成人身体质量指数[BMI]≥25，儿童BMI-Z≥1.65）、视觉功能、内分泌功能和社会参与度方面评估功能预后。我们研究了患者特征、肿瘤大小、肿瘤位置、下丘脑受累情况、手术引起的下丘脑损伤、切除范围和复发率是否与这些功能预后因素相关。
诊断时的中位年龄为28.0岁，中位随访时间为80.5个月。22例患者术后出现肥胖，术后肥胖患者术前BMI或BMI-Z显著更高（成人术前BMI：p = 0.074；儿童术前BMI-Z：p = 0.020），且与术前下丘脑受累2级（p = 0.012）和手术引起的下丘脑损伤II级（p = 0.0001）显著相关。社会参与度下降与更大的肿瘤大小（p = 0.023）和肿瘤复发（p = 0.0047）显著相关。
术前BMI或BMI-Z较高且下丘脑受累的患者术后肥胖风险更大，更大的肿瘤大小和复发会显著降低患者的社会参与率。
