CP-11. BODY MASS INDEX INCREASE FOLLOWING CHILDHOOD CRANIOPHARYNGIOMA SURGERY IS MOST SEVERE IN THE FIRST THREE MONTHS; TIME TO ACT!

Abstract

Abstract BACKGROUND Centralization of care for childhood craniopharyngioma (cCP) in the Netherlands (June 2018), including the involvement of a multidisciplinary team, has resulted in a decreased prevalence of hypothalamic obesity. Unfortunately, in certain patients, increasing body mass index standard deviation scores (BMI SDS) are still encountered after tumor resection. The aim of this analysis is to identify timing of BMI change, incidence/prevalence and predictive factors for BMI changes enabling early preventive strategies. METHODS A retrospective cohort study was performed of all newly diagnosed cCP patients since centralization of care in the Netherlands (June 2018). Data on anthropometrics, radiology, tumor treatment (surgery, radiotherapy, interferon and tocilizumab), hypothalamic-pituitary function, medication and visual function, were collected. Uni- and multivariate analyses were done with the ‘mean’ change in BMI SDS at 3, 6 and 12 months after resection as primary endpoint. Body mass index trends were assessed as secondary outcome. RESULTS Of 34 patients, median age 8.93 (range 0.79-17.36), mean ∆BMI SDS was most pronounced at 3 months (+1.09 SDS (SD 1.17), p<0.01), followed by a further mean increase of +0.25 SDS from 3 to 6 months (SD 0.50, p=0.01). In 17 patients, BMI SDS increased with ≥1.0 SDS in the first 3 months after resection (50%). A Muller grade 2 at diagnosis was associated with ∆BMI SDS at 3 months. Children with the highest BMI at diagnosis had the highest BMI at three months, but not the highest ∆BMI SDS. CONCLUSION Changes in BMI SDS ≥1.0 are observed in half of cCP patients following surgical resection despite expert multidisciplinary care, with most pronounced BMI changes during the first 3 months. These observations are a plea for more early interventions to prevent (morbid) hypothalamic obesity.