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Long-term weight gain in children with craniopharyngioma

Sibylle Rovani1, Victoria Butler2, Dinane Samara-Boustani1

  • 1Paediatric Endocrinology, Diabetology, Gynaecology Department, Necker-Enfants Malades University Hospital, AP-HP Centre, Paris 75015, France.

European Journal of Endocrinology
|April 25, 2024
PubMed

Insights

Children treated for craniopharyngioma experience significant weight gain, even with hypothalamus-sparing approaches. Maintaining hypothalamus integrity is linked to less weight gain, but hypothalamic obesity remains a concern.

Area of Science:

  • Pediatric Endocrinology
  • Pediatric Oncology
  • Neuro-oncology

Background:

  • Adamantinomatous craniopharyngioma is a pediatric brain tumor.
  • Excessive weight gain is a common long-term complication in survivors.
  • Understanding weight changes and associated risk factors is crucial for patient management.

Purpose of the Study:

  • To assess long-term weight changes in children treated for craniopharyngioma.
  • To identify risk factors contributing to excessive weight gain.
  • To investigate the association between hypothalamic damage and weight gain.

Main Methods:

  • Retrospective cohort study of 108 children managed between 1990 and 2019.
  • Comparison of body mass index (BMI) standard deviation scores (SDS) at baseline and last follow-up.
  • Univariate and multivariate analyses to identify variables associated with BMI-SDS variation.

Main Results:

  • Mean BMI-SDS increased significantly over 10.4 years of follow-up (2.11 overall).
  • Less weight gain was observed in patients without hypothalamic involvement (tumor or treatment).
  • Factors associated with BMI-SDS change >2 included female sex, hypothalamic tumor involvement, and higher baseline BMI.

Conclusions:

  • Clinically significant weight gain is nearly universal in pediatric craniopharyngioma survivors.
  • Hypothalamus integrity is associated with reduced weight gain, but hypothalamic obesity persists.
  • Novel treatment strategies are needed to address persistent weight gain despite hypothalamus-sparing approaches.
Abstract

Keywords:
craniopharyngiomagrowthhypothalamic obesitypaediatric patientsweight

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