Endocrine Abstracts

Background: Quality of life (QoL) has become a critical component of therapeutic outcomes in the survivors of childhood-onset craniopharyngioma (CP). Visual deficiency adversely affects daily functioning and QoL in childhood CP. This cohort study aimed to report the vision-related QoL in CP patients.

Methods: 120 patients with CP were included in this study and prospectively observed. The primary outcome measure was pediatric QoL (PEDQOL score) in patients with and without visual impairment from presentation at the time of CP diagnosis to three-year follow-up. Potential risk factors associated with visual impairment were analyzed using multivariable logistic regression.

Results: The most common presenting symptoms at the time of CP diagnosis were headache (42%), visual impairment (20%), and growth retardation (12%). Visual impairment was found in 87 patients (70%). Ophthalmologic examination and PEDQOL scores, which were grouped into seven domains: physical functioning, cognition, social functioning friends, social functioning family, and body image, were evaluated at the third month, first-year, and third-year after diagnosis. Parents of children with visual impairment report worse social functioning in their families than parents of children without visual impairment, one (P=0.017) and three years (P=0.011) after diagnosis. After three years, children with visual impairment were found to have worse quality of life in the autonomy domain of self- (P=0.029) and parental assessment (P=0.048). High tumor volume (>21 cm³), radiation therapy and extrasellar tumor location were identified as potential risk factors for visual impairment.

Conclusions: We conclude that visual impairment has a negative impact on QoL after CP. Early detection of visual impairment, regular QoL assessment, and risk-appropriate follow-up care are recommended.