Craniopharyngioma in the Elderly: A Multicenter and Nationwide Study in Spain

Background: Craniopharyngioma (CP) is a rare tumor in the elderly whose clinical features and prognosis are not well known in this population. Aim: To evaluate the clinicopathological features and therapeutic outcomes of CP diagnosed in the elderly. Patients and Methods: This was a retrospective, mu...

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Autores: Iglesias, P, Nocete, I, Rodriguez, MDM, Venegas-Moreno, E, Ares, J, Biagetti, B, Berrocal, VR, Guerrero-Perez, F, Vicente, A, Villar-Taibo, R, Cordido, F, Paja, M, Glerean, M, Rivera, NG, Fuentes, ED, Blanco, C, Alvarez-Escola, C, Martin, T, Webb, SM, Bernabeu, I, Villabona, C, Soto-Moreno, A, Gaztambide, S, Diez, JJ
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2021
País:España
Institución:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
Repositorio:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
OAI Identifier:oai:iibsantpau.fundanetsuite.com:p5430
Acceso en línea:https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=5430
http://hdl.handle.net/2183/29867
Access Level:acceso abierto
Palabra clave:Craniopharyngioma
Elderly
Diabetes insipidus
Hypopituitarism
Visual field defects
Neurosurgery
Therapeutic outcome
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spelling Craniopharyngioma in the Elderly: A Multicenter and Nationwide Study in SpainIglesias, PNocete, IRodriguez, MDMVenegas-Moreno, EAres, JBiagetti, BBerrocal, VRGuerrero-Perez, FVicente, AVillar-Taibo, RCordido, FPaja, MGlerean, MRivera, NGFuentes, EDBlanco, CAlvarez-Escola, CMartin, TWebb, SMBernabeu, IVillabona, CSoto-Moreno, AGaztambide, SDiez, JJCraniopharyngiomaElderlyDiabetes insipidusHypopituitarismVisual field defectsNeurosurgeryTherapeutic outcomeBackground: Craniopharyngioma (CP) is a rare tumor in the elderly whose clinical features and prognosis are not well known in this population. Aim: To evaluate the clinicopathological features and therapeutic outcomes of CP diagnosed in the elderly. Patients and Methods: This was a retrospective, multicenter, national study of CP patients diagnosed over the age of 65 years and surgically treated. Results: From a total of 384 adult CP patients, we selected 53 (13.8%) patients (27 women [50.9%], mean age 72.3 +/- 5.1 years [range 65-83 years]) diagnosed after the age of 65 years. The most common clinical symptoms were visual field defects (71.2%) followed by headache (45.3%). The maximum tumor diameter was 2.9 +/- 1.1 cm. In most patients, the tumor was suprasellar (96.2%) and mixed (solid-cystic) (58.5%). The surgical approach most commonly used was transcranial surgery (52.8%), and more than half of the patients (54.7%) underwent subtotal resection (STR). Adamantinomatous CP and papillary CP were present in 51 and 45.1%, respectively, with mixed forms in the remaining. Surgery was accompanied by an improvement in visual field defects and in headaches; however, pituitary hormonal hypofunction increased, mainly at the expense of an increase in the prevalence of diabetes insipidus (DI) (from 3.9 to 69.2%). Near-total resection (NTR) was associated with a higher prevalence of DI compared with subtotal resection (87.5 vs. 53.6%, p = 0.008). Patients were followed for 46.7 +/- 40.8 months. The mortality rate was 39.6% with a median survival time of 88 (95% CI: 57-118) months. DI at last visit was associated with a lower survival. Conclusion: CP diagnosed in the elderly shows a similar distribution by sex and histologic forms than that diagnosed at younger ages. At presentation, visual field alterations and headaches are the main clinical symptoms which improve substantially with surgery. However, surgery, mainly NTR, is accompanied by worsening of pituitary function, especially DI, which seems to be a predictor of mortality in this population.KARGER2021info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=5430http://hdl.handle.net/2183/29867NEUROENDOCRINOLOGYISSN: 00283835ISSNe: 14230194reponame:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pauinstname:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)Inglésinfo:eu-repo/semantics/openAccessoai:iibsantpau.fundanetsuite.com:p54302026-06-14T12:41:47Z
dc.title.none.fl_str_mv Craniopharyngioma in the Elderly: A Multicenter and Nationwide Study in Spain
title Craniopharyngioma in the Elderly: A Multicenter and Nationwide Study in Spain
spellingShingle Craniopharyngioma in the Elderly: A Multicenter and Nationwide Study in Spain
Iglesias, P
Craniopharyngioma
Elderly
Diabetes insipidus
Hypopituitarism
Visual field defects
Neurosurgery
Therapeutic outcome
title_short Craniopharyngioma in the Elderly: A Multicenter and Nationwide Study in Spain
title_full Craniopharyngioma in the Elderly: A Multicenter and Nationwide Study in Spain
title_fullStr Craniopharyngioma in the Elderly: A Multicenter and Nationwide Study in Spain
title_full_unstemmed Craniopharyngioma in the Elderly: A Multicenter and Nationwide Study in Spain
title_sort Craniopharyngioma in the Elderly: A Multicenter and Nationwide Study in Spain
dc.creator.none.fl_str_mv Iglesias, P
Nocete, I
Rodriguez, MDM
Venegas-Moreno, E
Ares, J
Biagetti, B
Berrocal, VR
Guerrero-Perez, F
Vicente, A
Villar-Taibo, R
Cordido, F
Paja, M
Glerean, M
Rivera, NG
Fuentes, ED
Blanco, C
Alvarez-Escola, C
Martin, T
Webb, SM
Bernabeu, I
Villabona, C
Soto-Moreno, A
Gaztambide, S
Diez, JJ
author Iglesias, P
author_facet Iglesias, P
Nocete, I
Rodriguez, MDM
Venegas-Moreno, E
Ares, J
Biagetti, B
Berrocal, VR
Guerrero-Perez, F
Vicente, A
Villar-Taibo, R
Cordido, F
Paja, M
Glerean, M
Rivera, NG
Fuentes, ED
Blanco, C
Alvarez-Escola, C
Martin, T
Webb, SM
Bernabeu, I
Villabona, C
Soto-Moreno, A
Gaztambide, S
Diez, JJ
author_role author
author2 Nocete, I
Rodriguez, MDM
Venegas-Moreno, E
Ares, J
Biagetti, B
Berrocal, VR
Guerrero-Perez, F
Vicente, A
Villar-Taibo, R
Cordido, F
Paja, M
Glerean, M
Rivera, NG
Fuentes, ED
Blanco, C
Alvarez-Escola, C
Martin, T
Webb, SM
Bernabeu, I
Villabona, C
Soto-Moreno, A
Gaztambide, S
Diez, JJ
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Craniopharyngioma
Elderly
Diabetes insipidus
Hypopituitarism
Visual field defects
Neurosurgery
Therapeutic outcome
topic Craniopharyngioma
Elderly
Diabetes insipidus
Hypopituitarism
Visual field defects
Neurosurgery
Therapeutic outcome
description Background: Craniopharyngioma (CP) is a rare tumor in the elderly whose clinical features and prognosis are not well known in this population. Aim: To evaluate the clinicopathological features and therapeutic outcomes of CP diagnosed in the elderly. Patients and Methods: This was a retrospective, multicenter, national study of CP patients diagnosed over the age of 65 years and surgically treated. Results: From a total of 384 adult CP patients, we selected 53 (13.8%) patients (27 women [50.9%], mean age 72.3 +/- 5.1 years [range 65-83 years]) diagnosed after the age of 65 years. The most common clinical symptoms were visual field defects (71.2%) followed by headache (45.3%). The maximum tumor diameter was 2.9 +/- 1.1 cm. In most patients, the tumor was suprasellar (96.2%) and mixed (solid-cystic) (58.5%). The surgical approach most commonly used was transcranial surgery (52.8%), and more than half of the patients (54.7%) underwent subtotal resection (STR). Adamantinomatous CP and papillary CP were present in 51 and 45.1%, respectively, with mixed forms in the remaining. Surgery was accompanied by an improvement in visual field defects and in headaches; however, pituitary hormonal hypofunction increased, mainly at the expense of an increase in the prevalence of diabetes insipidus (DI) (from 3.9 to 69.2%). Near-total resection (NTR) was associated with a higher prevalence of DI compared with subtotal resection (87.5 vs. 53.6%, p = 0.008). Patients were followed for 46.7 +/- 40.8 months. The mortality rate was 39.6% with a median survival time of 88 (95% CI: 57-118) months. DI at last visit was associated with a lower survival. Conclusion: CP diagnosed in the elderly shows a similar distribution by sex and histologic forms than that diagnosed at younger ages. At presentation, visual field alterations and headaches are the main clinical symptoms which improve substantially with surgery. However, surgery, mainly NTR, is accompanied by worsening of pituitary function, especially DI, which seems to be a predictor of mortality in this population.
publishDate 2021
dc.date.none.fl_str_mv 2021
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=5430
http://hdl.handle.net/2183/29867
url https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=5430
http://hdl.handle.net/2183/29867
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv KARGER
publisher.none.fl_str_mv KARGER
dc.source.none.fl_str_mv NEUROENDOCRINOLOGY
ISSN: 00283835
ISSNe: 14230194
reponame:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
instname:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
instname_str Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
reponame_str r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
collection r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
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repository.mail.fl_str_mv
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