ECE2021 Audio Eposter Presentations Pituitary and Neuroendocrinology (113 abstracts)
1University Childrens Hospital, Car von Ossietzky University Oldenburg, Department of Pediatrics and Pediatric Hematology/Oncology, Klinikum Oldenburg AöR, Oldenburg, Germany; 2Augsburg Hospital, Department of Neuroradiology, Augsburg, Germany; 3University Hospital Würzburg, Department of Neuroradiology, Würzburg, Germany; 4University Münster, Institute of Biostatistics and Clinical Research, Münster, Germany; 5University Hospital UKE Hamburg-Eppendorf, Department of Neurosurgery, 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: 0.553 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.