Quality of life and behavioral follow-up study of pediatric survivors of craniopharyngioma

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Object

The authors set out to evaluate the quality of life (QOL), social—emotional functioning, and behavioral functioning of children treated surgically for craniopharyngiomas.

Methods

Twelve girls and 17 boys with a mean age at diagnosis of 8 ± 3.8 years were surgically treated between 1985 and 1998 at the New York University Medical Center. After a mean follow-up period of 6.8 ± 3.5 years, these 29 patients were administered either the 36-item Short Form Health Survey version 2 or the Child Health Questionnaire—Parent Form to assess QOL, as well as the Achenbach Child Behavior Checklist or Young Adult Checklist to measure social—emotional and behavioral functioning. Patients older than 19 years of age and parents of patients younger than 19 years of age reported low average overall physical QOL, with overall psychosocial QOL in the average range. Behavioral difficulties were noted, including internalizing, attention, somatic, and social difficulties. Further analyses indicated that retrochiasmatic tumor location, recurrence, and additional surgery were associated with poorer outcomes. In contrast, hydrocephalus, tumor size, and sex were not prognostic variables, and patients significantly improved as postoperative time increased.

Conclusions

Attention toward late effects arising after the treatment of pediatric craniopharyngioma, including decreased postoperative physical health and behavioral functioning, is warranted. Future approaches to treatment should consider the documented effects of either gross-total resection or limited surgery followed by cranial irradiation on QOL, with specific evaluation for those with retrochiasmatic tumors, a recurrent tumor, or the need for additional surgery. Psychosocial QOL and social—emotional functioning should be maintained through ongoing counseling and education.

Article Information

Address reprint requests to: Stephen A. Sands, Psy.D., Herbert Irving Child and Adolescent Oncology Center, Columbia University College of Physicians and Surgeons, 161 Fort Washington Avenue-IP7, New York, New York 10032. email: ss2341@columbia.edu.

© AANS, except where prohibited by US copyright law.

Headings

Figures

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    Graphs depicting overall psychosocial QOL (PSS; upper) and physical QOL (PHS; lower) for patients 18 years of age or younger at the time of follow up by recurrence status.

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