Long-term weight development and psychosocial status in childhood Craniopharyngioma patients

Background: Craniopharyngioma (CP) are the most common sellar tumors in children. Patients often develop excessive weight gain and obesity due to several factors as involvement or damage of the hypothalamus. Previous studies on the weight development in CP patients have shown an increase in weight before and in the first ten years after diagnosis leading to an impaired quality of life. The long-term weight development in these patients has not been investigated till now.

Patients and methods: In a retrospective study, we analysed the weight development of 108 CP patients who were diagnosed before 2001. Data from physical examinations, anthropometric measurements and the patient's records were used, as well as a questionnaire answered by the patients in 2011 on their current weight and psychosocial status. The BMI SDS of the patients at diagnosis, 8 – 12 years after diagnosis, during long-term follow-up and at the time they answered the questionnaire was analysed and several factors were investigated for their effect on the weight development.

Results: Long-term survivors of CP were assessed at a median age of 26.1 (range 14.8 – 42.7) after a median follow up of 17.0 years (range 8.8 – 33.4) after CP diagnosis. All patients show an increase in BMI SDS during the first ten years after diagnosis, as previously published. During long-term follow-up (more than 12 years after diagnosis), though, no further weight increase is seen. Patients with hypothalamic involvement of CP show a higher initial weight increase, but a stabilisation as well. Patients with a normal BMI at diagnosis (-2 to +2SD) show the highest weight increase during the first ten years after diagnosis, whereas patients, who are overweight at diagnosis (BMI > 3SD) show a smaller increase in BMI SDS during long-term follow-up.

Conclusion: We conclude that the degree of obesity in CP reaches a certain plateau during long-term follow-up.