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- Title
Bariatric Surgery for Hypothalamic Obesity in Craniopharyngioma Patients: A Retrospective, Matched Case-Control Study.
- Authors
van Santen, Selveta S.; Wolf, Peter; Kremenevski, Natalia; Boguszewski, Cesar L.; Beiglböck, Hannes; Fiocco, Marta; Wijnen, Mark; Wallenius, Ville R.; van den Heuvel-Eibrink, Marry M.; van der Lely, Aart J.; Johannsson, Gudmundur; Luger, Anton; Krebs, Michael; Buchfelder, Michael; Delhanty, Patric J. D.; Neggers, Sebastian J. C. M. M.; Olsson, Daniel S.
- Abstract
<bold>Context: </bold>Craniopharyngioma is a sellar tumor associated with high rates of pituitary deficiencies (~ 98%) and hypothalamic obesity (~ 50%).<bold>Objective: </bold>This work aims to determine the efficacy regarding long-term weight loss after bariatric surgery in obese craniopharyngioma patients with hypothalamic dysfunction.<bold>Methods: </bold>This retrospective, case-control, multicenter, international study included obese craniopharyngioma patients (N = 16; of whom 12 are women) with a history of bariatric surgery (12 Roux-en-Y gastric bypass, 4 sleeve gastrectomy; median age 21 years [range, 15-52 years], median follow-up 5.2 years [range, 2.0-11.3 years]) and age/sex/surgery/body mass index-matched obese controls (N = 155). Weight loss and obesity-related comorbidities up to 5 years after bariatric surgery were compared and changes in hormonal replacement therapy evaluated.<bold>Results: </bold>Mean weight loss at 5-year follow-up was 22.0% (95% CI, 16.1%-27.8%) in patients vs 29.5% (95% CI, 28.0%-30.9%) in controls (P = .02), which was less after Roux-en-Y gastric bypass (22.7% [16.9%-28.5%] vs 32.0% [30.4%-33.6%]; P = .003) but at a similar level after sleeve gastrectomy (21.7% [-1.8% to 45.2%] vs 21.8% [18.2%-25.5%]; P = .96). No major changes in endocrine replacement therapy were observed after surgery. One patient died (unknown cause). One patient had long-term absorptive problems.<bold>Conclusion: </bold>Obese patients with craniopharyngioma had a substantial mean weight loss of 22% at 5-year follow-up after bariatric surgery, independent of type of bariatric surgery procedure. Weight loss was lower than in obese controls after Roux-en-Y gastric bypass. Bariatric surgery appears to be effective and relatively safe in the treatment of obese craniopharyngioma patients.
- Subjects
BARIATRIC surgery; HYPOTHALAMIC hormones; CRANIOPHARYNGIOMA; OBESITY; RETROSPECTIVE studies; PROGNOSIS; CASE-control method; GASTRIC bypass; BODY mass index; LONGITUDINAL method; DISEASE complications
- Publication
Journal of Clinical Endocrinology & Metabolism, 2021, Vol 106, Issue 11, pe4734
- ISSN
0021-972X
- Publication type
journal article
- DOI
10.1210/clinem/dgab518