Risk Factor and Replacement Therapy Analysis of Pre- and Postoperative Endocrine Deficiencies for Craniopharyngioma

SIMPLE SUMMARY: Although craniopharyngiomas are pathologically defined as benign tumors, their lesions could involve the hypothalamic–pituitary axis and adjacent to several important anatomical structures. Treatment strategies, including surgery and radiation, have a higher risk of damaging these important structures, which leads to excess recurrence and disability rates. Endocrine deficiencies caused by hypothalamic–pituitary axis damage are the most common symptoms and postoperative complications of craniopharyngioma patients, which severely affect perioperative and long-term treatment effects. However, limited studies have focused on the endocrine deficiencies of craniopharyngioma patients. In this study, the influencing factors and replacement therapies for pre- and postoperative pituitary hormone deficiency were retrospectively analyzed in 126 craniopharyngioma patients, which provides evidence for surgical strategy selection and long-term management during craniopharyngioma treatments. ABSTRACT: Background: Pituitary hormone deficiency (PHD) is one of the most common symptoms and postoperative complications of craniopharyngiomas (CPs). However, the risk factors for PHD in CPs are little known. The purpose of this study was to analyze the risk factors of pre- and postoperative PHD and to investigate replacement therapy for CP patients. Methods: A retrospective study of 126 patients diagnosed with CP was performed. Univariate analysis was performed using Pearson’s chi-squared test or Fisher’s exact test, and a multiple logistic binary regression model was used to identify the influencing factors of pre- and postoperative PHD in craniopharyngioma. Results: Children and patients with hypothalamic involvement were more likely to have preoperative PHD. Patients with suprasellar lesions had a high risk of postoperative PHD, and preoperative PHD was a risk factor for postoperative PHD. Conclusion: Children have a high incidence of preoperative PHD. Preoperative PHD can serve as an independent risk factor for postoperative PHD. Preoperative panhypopituitarism can serve as an indication of pituitary stalk sacrifice during surgery. The management of replacement therapy for long-term postoperative endocrine hormone deficiency in patients with craniopharyngioma should be enhanced.