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[Childhood craniopharyngioma with hypothalamic obesity - no long-term weight reduction due to rehabilitation
A S Sterkenburg1, A Hoffmann2, U Gebhardt2
1University Medical Center (UMCG), University of Groningen, Groningen, Netherlands.
Insights
Rehabilitation efforts did not show long-term weight reduction in childhood craniopharyngioma survivors with hypothalamic obesity. Further research is needed to improve treatment strategies and patient prognosis.
Area of Science:
- Pediatric Endocrinology
- Neuro-oncology
- Obesity Research
Context:
- Childhood craniopharyngioma survivors often develop severe obesity due to hypothalamic damage.
- Long-term effects of rehabilitation on weight management in these patients remain under-analyzed.
Purpose:
- To analyze the long-term weight development in childhood craniopharyngioma survivors after rehabilitation interventions.
- To evaluate the effectiveness of rehabilitation in managing hypothalamic obesity in this patient cohort.
Summary:
- This study analyzed 108 childhood craniopharyngioma patients, with 31 undergoing rehabilitation for hypothalamic obesity.
- Patients receiving rehabilitation had higher BMIs at diagnosis and follow-up compared to those without.
- No significant long-term weight-reducing effect of rehabilitation was detected, irrespective of obesity severity or rehabilitation frequency.
Impact:
- Current rehabilitation options for hypothalamic obesity in craniopharyngioma survivors are limited.
- Future strategies should focus on preventing hypothalamic lesions and addressing psychosocial aspects of rehabilitation to improve long-term outcomes.
Background:
Severe obesity due to hypothalamic involvement has major impact on prognosis in long-term survivors of childhood craniopharyngioma. The long-term effects of rehabilitation efforts on weight development and obesity in these patients are not analyzed up to now.
Patients And Methods:
108 patients with childhood craniopharyngioma recruited in HIT Endo before 2001 were included in the study. Long-term weight development (BMI SDS after >10 yrs follow-up) was analyzed in regard to rehabilitation, which was performed in 31 of 108 (29%) patients (one rehabilitation in 4 patients (13%), more than one in 21 patients (68%), 6 patients unknown) in 13 German rehabilitation -clinics.
Results:
84% of patients underwent rehabilitation in order to reduce hypothalamic obesity (BMI>+ 2 SD), whereas 12% of patients were normal weight. Childhood craniopharyngioma pa-tients with rehabilitation presented with higher BMI at diagnosis (median BMI: +1.32 SD; range: -1.08 to + 7.00 SD) and at last evaluation (median BMI: +4.93 SD; range: -0.20 to + 13.13 SD) when compared with patients without rehabilitation (median BMI at diagnosis: +0.24 SD; range: -2.67 to + 6.98 SD; BMI at evaluation: +2.09 SD; range: -1.48 to + 10.23 SD). A long-term weight reducing effect of rehabilitation was no detectable regardless of degree of obesity, frequency of rehabilitation, and hospital of rehabilitation.
Conclusion:
Treatment options for hypothalamic obesity in terms of rehabilitation are limited. Accordingly, strategies for prevention of hypothalamic lesions and psychosocial effects of rehabilitation are currently in focus for improvement of prognosis in childhood craniopharyngioma patients.
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