Hypothalamic–pituitary function following childhood brain tumors: Analysis of prospective annual endocrine screening

Lawson, Sarah; Horne, Vincent E.; Golekoh, Marjorie C.; Hornung, Lindsey; Burns, Karen; Fouladi, Maryam; Rose, Susan R.

doi:10.1002/pbc.27631

Cited by 22 publications

(30 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our median follow-up period was comparable to that in previously published studies, being 12 years in childhood-onset and 14 years in adult-onset CP [7,[38][39][40]. The shorter followup period in pCP patients could influence our results, yet it was determined that pituitary hormonal deficiency rarely appears more than 6 years after tumor diagnosis and treatment [42]. Therefore, we presume that the duration of follow-up could mostly affect the lower prevalence of metabolic, but not the endocrine, complications in pCP patients.…”

Section: Discussionsupporting

confidence: 80%

Prevalence of Endocrine and Metabolic Comorbidities in a National Cohort of Patients with Craniopharyngioma

et al. 2020

View full text Add to dashboard Cite

Objective: The major part of craniopharyngioma (CP) morbidity is the tumor and/or treatment-related damage, which results in impaired function of the hypothalamic-pituitary axes and metabolic derangements. The aim of the study was to analyze the prevalence of long-term endocrine and metabolic comorbidities in a national cohort of CP patients based on the age at diagnosis and histology criteria. Design: A retrospective-prospective longitudinal cohort analysis. Methods: Forty-six patients with CP treated from 1979 onwards (19 with childhood-onset disease) in a single university institution were included in our study. Median follow-up from presentation was 12.8 years (interquartile range: 8.3-22.2 years) and comparable between age-at-diagnosis and histological subtype groups. Data on tumor histology were extracted from patients' records and re-evaluated if tissue samples were available (n = 32). Results: Childhood-onset patients presented more frequently with headache, and adult-onset with visual impairment. Prevalence of at least one pituitary axis affected increased from 54% at presentation to 100% at follow-up in childhood-onset and from 41 to 93% in adult-onset CP. Growth hormone deficiency, central diabetes insipidus, and panhypopituitarism were more prevalent in childhood-onset adamantinomatous CP (aCP) and least prevalent in adult-onset papillary CP (pCP). At followup, metabolic syndrome (MetS) was diagnosed in 80% of childhood-onset and 68% of adult-onset patients (p = 0.411). In the latter group, it tended to be more frequent in the aCP than pCP subtype (80 vs. 50%, p = 0.110). Conclusions: Long-Long-Term Outcomes in Craniopharyngioma 47 Horm Res Paediatr 2020;93:46-57 term endocrine and metabolic complications are very frequent in childhood-and adult-onset CP patients of both histological subtypes. The prevalence of MetS was higher compared to the largest cohort previously reported.

show abstract

Section: Discussionsupporting

confidence: 80%

Prevalence of Endocrine and Metabolic Comorbidities in a National Cohort of Patients with Craniopharyngioma

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Overall, 37.1% of childhood brain tumor survivors were diagnosed with at least 1 endocrine disorder. Previous studies have also reported the prevalence of endocrine disease among childhood brain tumor survivors to be 40% (9,11). Most endocrine disorders were identified at a median duration of 26.3 (range=0.1-96.7) months of follow-up, with the peak occurring soon after the diagnosis of the tumors.…”

Section: Discussionmentioning

confidence: 90%

Prevalence of Endocrine Disorders in Childhood Brain Tumor Survivors in South Korea

Heo

Lee

Hwang

et al. 2019

In Vivo

View full text Add to dashboard Cite

Background/Aim: This longitudinal study aimed to analyze the prevalence of endocrine disorders in childhood brain tumor survivors in South Korea using claims data. Patients and Methods: We identified in 1,058 patients from a nationwide cohort of patients diagnosed with brain tumors between January 1st 2009 to March 29th 2016. Multivariable logistic regression was used to evaluate associations between clinical factors and endocrine disorders. Results: After a median follow-up of 60.0 months, 393 (37.1%) patients had at least 1 endocrine disorder. The commonest endocrine disorders were hypopituitarism (17.4%) and hypothyroidism (6.1%). Female gender (odds ratio(OR)=1.45, p=0.005) and age <10 years (OR=1.65, p=0.001) conferred a higher risk. Patients who received radiotherapy were more likely to have endocrine disorders compared to those who did not (OR=1.79, p<0.001). Conclusion: Regular assessment of endocrine function and timely interventions are necessary for childhood brain tumor survivors with a risk of endocrine disorders. Brain tumors are the second commonest cause of cancer in children and account for 21% of all pediatric cancers (1). Advancements in treatment have allowed 74% of children diagnosed with brain tumors to become long-term survivors (2). Despite improvements in prognosis, cancer survivors continue to suffer from treatment-related side-effects that impair their quality of life (3). These adverse effects may be related to the tumor burden, surgical interventions, chemotherapy, or radiotherapy (4). Many of the late effects are attributable to direct damage of brain development (5), and include disorders of the endocrine system (6). Among them, childhood brain tumors located near the hypothalamic-pituitary area are particularly associated with an increased risk of hypothalamic pituitary axis (HPA) dysfunction (7). Common endocrine complications include the growth hormone (GH) deficiency and insufficient levels of thyrotropic and adrenocorticotropic hormones (8). In addition, the prevalence of endocrine disease among patients with childhood brain tumors is 49%, and that of more than one endocrine deficiency is estimated to be 40% (9). Reports suggest that the lack of an appropriate and timely follow-up escaping diagnosis of developing endocrine disorders could result in late referrals, adversely affecting the hormone balance of these patients (10). Reports on the number of childhood brain tumor survivors being currently treated for endocrine disorders in South Korea are scarce. In addition, recommendations for screening endocrinopathy are based on limited variables and as a result of studies in small patient populations (11). For all these reasons, we aimed to analyze large-scale nationwide data for identifying the prevalence of endocrine disorders among childhood brain tumor survivors. We also evaluated the risk factors associated with these disorders. Patients and Methods Patients under 18 years of age who were diagnosed with pediatric brain tumors between January 2007 and December 2016 were ident...

show abstract

“…These findings are inconsistent with most reports in the literature. For example, Ramanauskiene et al, 7 Lawson et al, 9 and Shalitin et al 6 found growth hormone deficiency to be the commonest endocrine disorder in those with childhood brain tumors (prevalence, 35.1% to 58.3%). In our study, only 7 patients (10%) underwent insulin tolerance testing and were found to have growth hormone deficiency (peak growth hormone cut-off value < 10 ng/mL).…”

Section: Discussionmentioning

confidence: 99%

Prevalence and Risk Factors for Endocrine Disorders in Childhood Brain Tumors From a Single Tertiary Center in Malaysia

Ng¹,

Jalaludin²,

Foo

et al. 2022

Journal of Pediatric Hematology/Oncology

View full text Add to dashboard Cite

Patients with childhood brain tumors are at risk of endocrine disorders. The prevalence of endocrine disorders varies across the world but is unknown in Malaysia. This study’s objectives were to determine the prevalence of endocrine disorders among children with brain tumors in Malaysia and to identify endocrinopathy-associated risk factors. We retrospectively reviewed the clinical data of pediatric patients with brain tumors diagnosed and treated at the University Malaya Medical Center from 1 January 2001 to 31 December 2015, with a follow-up period until the age of 18 years old or at least 3 years from the initial diagnosis. A total of 106 patients were included; 71 patients (66%) were screened for endocrine disorders, and 61% of these had endocrine disorders at a median follow-up of 4 years. Hypothyroidism, short stature, and adrenocortical insufficiency were present in one-third of the patients, followed by central diabetes insipidus (21%), growth hormone deficiency (10%), delayed puberty (9%), and precocious puberty (4%). Radiation therapy and surgical intervention were risk factors for endocrine disorders, but hydrocephalus, supratentorial tumors, and malignant tumors were not. Most endocrinopathies developed within the first 2 years of brain tumor diagnosis. Therefore, standard endocrine-monitoring guidelines aiming for early diagnosis and therapy are essential.

show abstract

Hypothalamic–pituitary function following childhood brain tumors: Analysis of prospective annual endocrine screening

Cited by 22 publications

References 28 publications

Prevalence of Endocrine and Metabolic Comorbidities in a National Cohort of Patients with Craniopharyngioma

Prevalence of Endocrine and Metabolic Comorbidities in a National Cohort of Patients with Craniopharyngioma

Prevalence of Endocrine Disorders in Childhood Brain Tumor Survivors in South Korea

Prevalence and Risk Factors for Endocrine Disorders in Childhood Brain Tumors From a Single Tertiary Center in Malaysia

Contact Info

Product

Resources

About