Health-Related Quality of Life in Adult Patients with Craniopharyngioma

Kristin Lucia; Peter Vajkoczy; David Kaul; Christian J Strasburger; Julia Onken

doi:10.1016/j.wneu.2021.06.119

Health-Related Quality of Life in Adult Patients with Craniopharyngioma

World Neurosurg. 2021 Oct:154:e46-e53. doi: 10.1016/j.wneu.2021.06.119. Epub 2021 Jul 2.

Authors

Kristin Lucia¹, Peter Vajkoczy², David Kaul³, Christian J Strasburger⁴, Julia Onken²

Affiliations

¹ Department of Neurosurgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany. Electronic address: kristin.lucia@kgu.de.
² Department of Neurosurgery, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
³ Department of Radiation Oncology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
⁴ Department of Endocrinology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.

PMID: 34224884
DOI: 10.1016/j.wneu.2021.06.119

Abstract

Objective: Craniopharyngiomas (CPs) are benign, dysontogenetic tumors associated with complex endocrinologic and neurologic symptoms and high morbidity. The aim of this study is to elucidate modifiable effectors of health-related quality of life (HrQoL) of adult patients with CP following neurosurgical intervention using standardized instruments as well as descriptive analysis.

Methods: HrQoL (European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire C30 and BN20) was evaluated in 20 adult patients with CP. We examined pre- as well as postoperative radiologic, hormonal, and symptom-oriented data in a retrospective analysis. Surgical approach, postoperative complications, and extent of resection were recorded. Additional descriptive analysis was performed on case records of all patients with HrQoL results.

Results: Long-term follow-up of HrQoL (mean of 75 months) was lower than the in healthy reference group (CP = 58, reference = 75). The most common postoperative complaints were endocrinologic disturbances (88%). Overall, univariate and multivariate logistic regression analysis revealed no significant predictors of reduced postoperative HrQoL. Descriptive analysis did, however, reveal a cluster of patients among those with the lowest global HrQoL which reported new postoperative anosmia and ageusia.

Conclusions: The global HrQoL of our cohort showed a substantial reduction compared with a healthy reference population. Postoperative hyposmia and ageusia is found in patients with the lowest postoperative HrQoL who otherwise had no new significant endocrinologic or neurologic complications. As these symptoms are not regularly accounted for in the HrQoL instruments used in this study, further analysis is needed to determine the possible significance of this complication in CP surgery, and it may affect the choice of surgical approach as well as the information patients receive before consenting to surgery.

Keywords: Anosmia; Craniopharyngioma; Quality of life.

MeSH terms

Adult
Aged
Ageusia / etiology
Ageusia / psychology
Anosmia / etiology
Anosmia / psychology
Brain Neoplasms / psychology*
Brain Neoplasms / surgery
Craniopharyngioma / psychology*
Craniopharyngioma / surgery
Endocrine System Diseases / etiology
Endocrine System Diseases / psychology
Female
Follow-Up Studies
Humans
Male
Middle Aged
Neurosurgical Procedures
Postoperative Complications / epidemiology
Postoperative Complications / psychology
Quality of Life*
Retrospective Studies
Socioeconomic Factors
Surveys and Questionnaires
Treatment Outcome
Young Adult