학술논문
Bariatric Surgery for Hypothalamic Obesity in Craniopharyngioma Patients: A Retrospective, Matched Case-Control Study
Clinical Research Article
Clinical Research Article
Document Type
Academic Journal
Author
Santen, Selveta S. van; Wolf, Peter; Kremenevski, Natalia; Boguszewski, Cesar L.; Beiglbock, Hannes; Fiocco, Marta; Wijnen, Mark; Wallenius, Ville R.; M. Heuvel-Eibrink, Marry van den; Lely, Aart J. van der; Johannsson, Gudmundur; Luger, Anton; Krebs, Michael; Buchfelder, Michael; Delhanty, Patric J.D.; J. C. M. Neggers, Sebastian M.; Olsson, Daniel S.
Source
Journal of Clinical Endocrinology & Metabolism. November 2021, Vol. 106 Issue 11, pe4734, 12 p.
Subject
Language
English
ISSN
0021-972X
Abstract
Craniopharyngiomas are rare brain tumors that mostly affect children or older adults (1-3). They are typically located in the sellar and suprasellar regions (1, 2). State-of-the-art treatment for craniopharyngiomas is [...]
Context: Craniopharyngioma is a sellar tumor associated with high rates of pituitary deficiencies (~ 98%) and hypothalamic obesity (~ 50%). Objective: This work aims to determine the efficacy regarding long-term weight loss after bariatric surgery in obese craniopharyngioma patients with hypothalamic dysfunction. Methods: This retrospective, case-control, multicenter, international study included obese craniopharyngioma patients (N-16; of whom 12 are women) with a history of bariatric surgery (12 Roux-en-Y gastric bypass, 4 sleeve gastrectomy; median age 21 years [range, 15-52 years], median follow-up 5.2 years [range, 2.0-11.3 years]) and age/sex/surgery/body mass indexmatched obese controls (N-155). Weight loss and obesity-related comorbidities up to 5 years after bariatric surgery were compared and changes in hormonal replacement therapy evaluated. Results: Mean weight loss at 5-yearfollow-up was 22.0% (95% CI, 16.1 %-27.8%) inpatients vs 29.5% (95% CI, 28.0%-30.9%) in controls (P=.02), which was less after Roux-en-Y gastric bypass (22.7% [16.9%-28.5%] vs 32.0% [30.4%-33.6%]; P=.003) but at a similar level after sleeve gastrectomy (21.7% [-1.8% to 45.2%] vs 21.8% [18.2%-25.5%]; P=.96). No major changes in endocrine replacement therapy were observed after surgery. One patient died (unknown cause). One patient had long-term absorptive problems. Conclusion: Obese patients with craniopharyngioma had a substantial mean weight loss of 22% at 5-year follow-up after bariatric surgery, independent of type of bariatric surgery procedure. Weight loss was lower than in obese controls after Roux-en-Y gastric bypass. Bariatric surgery appears to be effective and relatively safe in the treatment of obese craniopharyngioma patients. Key Words: craniopharyngioma, hypothalamic obesity, hypothalamic dysfunction, bariatric surgery, weight loss, case-control study
Context: Craniopharyngioma is a sellar tumor associated with high rates of pituitary deficiencies (~ 98%) and hypothalamic obesity (~ 50%). Objective: This work aims to determine the efficacy regarding long-term weight loss after bariatric surgery in obese craniopharyngioma patients with hypothalamic dysfunction. Methods: This retrospective, case-control, multicenter, international study included obese craniopharyngioma patients (N-16; of whom 12 are women) with a history of bariatric surgery (12 Roux-en-Y gastric bypass, 4 sleeve gastrectomy; median age 21 years [range, 15-52 years], median follow-up 5.2 years [range, 2.0-11.3 years]) and age/sex/surgery/body mass indexmatched obese controls (N-155). Weight loss and obesity-related comorbidities up to 5 years after bariatric surgery were compared and changes in hormonal replacement therapy evaluated. Results: Mean weight loss at 5-yearfollow-up was 22.0% (95% CI, 16.1 %-27.8%) inpatients vs 29.5% (95% CI, 28.0%-30.9%) in controls (P=.02), which was less after Roux-en-Y gastric bypass (22.7% [16.9%-28.5%] vs 32.0% [30.4%-33.6%]; P=.003) but at a similar level after sleeve gastrectomy (21.7% [-1.8% to 45.2%] vs 21.8% [18.2%-25.5%]; P=.96). No major changes in endocrine replacement therapy were observed after surgery. One patient died (unknown cause). One patient had long-term absorptive problems. Conclusion: Obese patients with craniopharyngioma had a substantial mean weight loss of 22% at 5-year follow-up after bariatric surgery, independent of type of bariatric surgery procedure. Weight loss was lower than in obese controls after Roux-en-Y gastric bypass. Bariatric surgery appears to be effective and relatively safe in the treatment of obese craniopharyngioma patients. Key Words: craniopharyngioma, hypothalamic obesity, hypothalamic dysfunction, bariatric surgery, weight loss, case-control study