Shigetoshi Yano1, Mareina Kudo2, Takuichiro Hide3, Naoki Shinojima3, Keishi Makino3, Hideo Nakamura3, Jun-Ichi Kuratsu3. 1. Department of Neurosurgery, Faculty of Life Sciences, Kumamoto University Graduate School, Kumamota, Japan. Electronic address: yanos@kumamoto-u.ac.jp. 2. Department of Neurosurgery, Hitoyoshi Medical Center, Kumamoto, Japan. 3. Department of Neurosurgery, Faculty of Life Sciences, Kumamoto University Graduate School, Kumamota, Japan.
Abstract
OBJECTIVE: Several studies have reported treatment methods and results for pediatric craniopharyngiomas; however, few have evaluated patients' quality of life (QOL) after long-term follow-up. To evaluate treatment options, we assessed the QOL of patients with pediatric craniopharyngioma approximately 19 years after surgery and analyzed factors affecting QOL. METHODS: Twenty-six survivors who underwent resection of craniopharyngiomas at <15 years of age enrolled in this study and their physical condition was assessed. QOL was assessed by a short-form health survey (SF-36 version 2) for patients older than 19 years of age or by Child Health Questionnaire Parent Form-50 for patients 18 years of age and younger. Patients were divided into good and fair QOL groups according to their physical and mental summary scores. Factors affecting the QOL of both groups were evaluated. RESULTS: Median follow-up time was 19.1 years (range, 2.8-44.1 years). Twenty-two (84.6%) patients were employed or in school; 14 (53.8%) had visual deficits. Panhypopituitarism was diagnosed in 22 of 26 (84.6%) subjects. SF-36 analysis indicated that patients had significantly lower scores for general and mental health. Visual deficits, obesity, and complications during follow-up significantly affected the fair QOL group long-term. Patients' basic characteristics, initial resection rates, times of operation or irradiation did not significantly affect long-term QOL. CONCLUSION: Long-term survivors lived independently but had a lower overall QOL. Not only monitor short-term results based on estimation of the initial resection or recurrence rate, it is important to preserve visual and hypothalamic function and monitor arising complications for extended periods to improve patients' long-term QOL.
OBJECTIVE: Several studies have reported treatment methods and results for pediatric craniopharyngiomas; however, few have evaluated patients' quality of life (QOL) after long-term follow-up. To evaluate treatment options, we assessed the QOL of patients with pediatric craniopharyngioma approximately 19 years after surgery and analyzed factors affecting QOL. METHODS: Twenty-six survivors who underwent resection of craniopharyngiomas at <15 years of age enrolled in this study and their physical condition was assessed. QOL was assessed by a short-form health survey (SF-36 version 2) for patients older than 19 years of age or by Child Health Questionnaire Parent Form-50 for patients 18 years of age and younger. Patients were divided into good and fair QOL groups according to their physical and mental summary scores. Factors affecting the QOL of both groups were evaluated. RESULTS: Median follow-up time was 19.1 years (range, 2.8-44.1 years). Twenty-two (84.6%) patients were employed or in school; 14 (53.8%) had visual deficits. Panhypopituitarism was diagnosed in 22 of 26 (84.6%) subjects. SF-36 analysis indicated that patients had significantly lower scores for general and mental health. Visual deficits, obesity, and complications during follow-up significantly affected the fair QOL group long-term. Patients' basic characteristics, initial resection rates, times of operation or irradiation did not significantly affect long-term QOL. CONCLUSION: Long-term survivors lived independently but had a lower overall QOL. Not only monitor short-term results based on estimation of the initial resection or recurrence rate, it is important to preserve visual and hypothalamic function and monitor arising complications for extended periods to improve patients' long-term QOL.
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