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Master Thesis

Impact des stratégies chirurgicales sur le syndrome hypothalamique des enfants opérés d’un craniopharyngiome

Abstract : Introduction: long-term quality of life in children with craniopharyngioma has become the main challenge of our treatment strategies. The aim of this study was to confirm the superiority of hypothalamus sparing surgery (HSS) over extensive resection surgery (ERS) in these children regarding the hypothalamic syndrome and obesity. Methods: we compared an historical cohort (HC) of children with craniopharyngioma who underwent an ERS at our institution between January 1985 and December 2002 to a prospective cohort (PC) who underwent a risk-related treatment strategy combining HSS and proton radiation therapy in the same department between January 2003 and January 2017. We collected, compared and critically analyzed the anthropometric (BMI Z-score), oncologic, surgical and hormonal outcomes in both groups. Results: sixty consecutives patients were included in the HC and 127 consecutives patients in the PC. Follow-up, demographical and preoperative anthropometrical data were comparable in both groups. BMI Z-scores were significantly lower in the PC group than in the HC group at 6 months (p < 0.05), 12 months (p < 0.01) and at last follow-up (p < 0.01). In the HC group, postoperative BMI Z-score were significantly increasing throughout follow-up (p < 0,.001) whereas children in the PC group stopped gaining weight at 6 months after surgery and their BMI Z-score remained stable until last follow-up (p< 0.001). In the PC group, gross total resection (GTR) was possible in 17.2% of the cases and subtotal resection with radiation therapy was performed in 71.1% of the cases. There was no difference in the number of surgical interventions per patient in both groups. Conclusion: HSS provides better long-term outcomes over the hypothalamic syndrome and obesity with comparable surgical outcomes and recurrences for childhood craniopharyngioma.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03208620
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Submitted on : Thursday, May 6, 2021 - 3:59:23 PM
Last modification on : Tuesday, September 7, 2021 - 3:23:51 AM

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  • HAL Id : dumas-03208620, version 1

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Etienne Lefevre. Impact des stratégies chirurgicales sur le syndrome hypothalamique des enfants opérés d’un craniopharyngiome. Médecine humaine et pathologie. 2019. ⟨dumas-03208620⟩

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