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Nomograms to Predict Endocrinological Deficiency in Patients With Surgically Treated Craniopharyngioma

OBJECTIVE: Postoperative hypopituitarism associated with increased risks of premature mobility and mortality is often encountered in craniopharyngioma patients. The aim of our study is to construct nomograms related to injury types of the hypothalamus–pituitary axis (HPA) to predict hypopituitarism...

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Autores principales: Wu, Jie, Wu, Xiao, Yang, Le, Xie, ShenHao, Tang, Bin, Tong, ZhiGao, Wu, BoWen, Yang, YouQing, Ding, Han, Bao, YouYuan, Zhou, Lin, Hong, Tao
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9161152/
https://www.ncbi.nlm.nih.gov/pubmed/35664729
http://dx.doi.org/10.3389/fonc.2022.840572
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author Wu, Jie
Wu, Xiao
Yang, Le
Xie, ShenHao
Tang, Bin
Tong, ZhiGao
Wu, BoWen
Yang, YouQing
Ding, Han
Bao, YouYuan
Zhou, Lin
Hong, Tao
author_facet Wu, Jie
Wu, Xiao
Yang, Le
Xie, ShenHao
Tang, Bin
Tong, ZhiGao
Wu, BoWen
Yang, YouQing
Ding, Han
Bao, YouYuan
Zhou, Lin
Hong, Tao
author_sort Wu, Jie
collection PubMed
description OBJECTIVE: Postoperative hypopituitarism associated with increased risks of premature mobility and mortality is often encountered in craniopharyngioma patients. The aim of our study is to construct nomograms related to injury types of the hypothalamus–pituitary axis (HPA) to predict hypopituitarism 1 year after surgery. METHODS: Craniopharyngioma patients undergoing initial endoscopic endonasal surgery between December 2012 and March 2021 in our center were retrospectively reviewed, and injury types of the HPA were categorized according to intraoperative endoscopic observation. Included patients were randomly divided into a training group and a validation group. Nomograms were established based on the results of multivariate logistic analysis. The predictive performance of the nomograms was evaluated in the training and validation groups. RESULTS: A total of 183 patients with craniopharyngioma were enrolled, and seven injury types of the HPA were summarized. Relative to intact HPA, exclusive hypothalamus injury significantly increased the risk of anterior (OR, 194.174; 95% CI, 21.311–1769.253; p < 0.001) and posterior pituitary dysfunction (OR, 31.393; 95% CI, 6.319–155.964; p < 0.001) 1 year after surgery, while exclusively sacrificing stalk infiltrated by tumors did not significantly increase the risk of anterior (OR, 5.633; 95% CI, 0.753–42.133; p = 0.092) and posterior pituitary dysfunction (OR, 1.580; 95% CI, 0.257–9.707; p = 0.621) 1 year after surgery. In the training group, the AUCs of nomograms predicting anterior and posterior pituitary dysfunction 1 year after surgery were 0.921 and 0.885, respectively, compared with 0.921 and 0.880 in the validation group. CONCLUSIONS: Intact hypothalamus structure is critical in maintaining pituitary function. Moreover, our preliminary study suggests that the pituitary stalk infiltrated by craniopharyngioma could be sacrificed to achieve radical resection, without substantially rendering significantly worse endocrinological efficiency 1 year after surgery. The user-friendly nomograms can be used to predict hypopituitarism 1 year after surgery.
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spelling pubmed-91611522022-06-03 Nomograms to Predict Endocrinological Deficiency in Patients With Surgically Treated Craniopharyngioma Wu, Jie Wu, Xiao Yang, Le Xie, ShenHao Tang, Bin Tong, ZhiGao Wu, BoWen Yang, YouQing Ding, Han Bao, YouYuan Zhou, Lin Hong, Tao Front Oncol Oncology OBJECTIVE: Postoperative hypopituitarism associated with increased risks of premature mobility and mortality is often encountered in craniopharyngioma patients. The aim of our study is to construct nomograms related to injury types of the hypothalamus–pituitary axis (HPA) to predict hypopituitarism 1 year after surgery. METHODS: Craniopharyngioma patients undergoing initial endoscopic endonasal surgery between December 2012 and March 2021 in our center were retrospectively reviewed, and injury types of the HPA were categorized according to intraoperative endoscopic observation. Included patients were randomly divided into a training group and a validation group. Nomograms were established based on the results of multivariate logistic analysis. The predictive performance of the nomograms was evaluated in the training and validation groups. RESULTS: A total of 183 patients with craniopharyngioma were enrolled, and seven injury types of the HPA were summarized. Relative to intact HPA, exclusive hypothalamus injury significantly increased the risk of anterior (OR, 194.174; 95% CI, 21.311–1769.253; p < 0.001) and posterior pituitary dysfunction (OR, 31.393; 95% CI, 6.319–155.964; p < 0.001) 1 year after surgery, while exclusively sacrificing stalk infiltrated by tumors did not significantly increase the risk of anterior (OR, 5.633; 95% CI, 0.753–42.133; p = 0.092) and posterior pituitary dysfunction (OR, 1.580; 95% CI, 0.257–9.707; p = 0.621) 1 year after surgery. In the training group, the AUCs of nomograms predicting anterior and posterior pituitary dysfunction 1 year after surgery were 0.921 and 0.885, respectively, compared with 0.921 and 0.880 in the validation group. CONCLUSIONS: Intact hypothalamus structure is critical in maintaining pituitary function. Moreover, our preliminary study suggests that the pituitary stalk infiltrated by craniopharyngioma could be sacrificed to achieve radical resection, without substantially rendering significantly worse endocrinological efficiency 1 year after surgery. The user-friendly nomograms can be used to predict hypopituitarism 1 year after surgery. Frontiers Media S.A. 2022-05-19 /pmc/articles/PMC9161152/ /pubmed/35664729 http://dx.doi.org/10.3389/fonc.2022.840572 Text en Copyright © 2022 Wu, Wu, Yang, Xie, Tang, Tong, Wu, Yang, Ding, Bao, Zhou and Hong https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Oncology
Wu, Jie
Wu, Xiao
Yang, Le
Xie, ShenHao
Tang, Bin
Tong, ZhiGao
Wu, BoWen
Yang, YouQing
Ding, Han
Bao, YouYuan
Zhou, Lin
Hong, Tao
Nomograms to Predict Endocrinological Deficiency in Patients With Surgically Treated Craniopharyngioma
title Nomograms to Predict Endocrinological Deficiency in Patients With Surgically Treated Craniopharyngioma
title_full Nomograms to Predict Endocrinological Deficiency in Patients With Surgically Treated Craniopharyngioma
title_fullStr Nomograms to Predict Endocrinological Deficiency in Patients With Surgically Treated Craniopharyngioma
title_full_unstemmed Nomograms to Predict Endocrinological Deficiency in Patients With Surgically Treated Craniopharyngioma
title_short Nomograms to Predict Endocrinological Deficiency in Patients With Surgically Treated Craniopharyngioma
title_sort nomograms to predict endocrinological deficiency in patients with surgically treated craniopharyngioma
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9161152/
https://www.ncbi.nlm.nih.gov/pubmed/35664729
http://dx.doi.org/10.3389/fonc.2022.840572
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