GH replacement does not increase the risk of recurrence in patients with craniopharyngioma
Summary Background A significant number of patients with craniopharyngioma are GH deficient. The safety of GH replacement in these subjects has not been established. Objective To assess the effect of GH replacement upon recurrence in patients with craniopharyngioma. Patients and methods All the p...
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| Veröffentlicht in: | Clinical endocrinology (Oxford) 2006-05, Vol.64 (5), p.556-560 |
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| creator | Karavitaki, Niki Warner, Justin T. Marland, Anne Shine, Brian Ryan, Fiona Arnold, Jayanth Turner, Helen E. Wass, John A. H. |
| description | Summary
Background A significant number of patients with craniopharyngioma are GH deficient. The safety of GH replacement in these subjects has not been established.
Objective To assess the effect of GH replacement upon recurrence in patients with craniopharyngioma.
Patients and methods All the patients with craniopharyngioma followed‐up at the Departments of Endocrinology or Paediatrics in Oxford and treated or not with GH were studied retrospectively. These were recruited from the databases of the departments consisting of subjects diagnosed between January 1964 and July 2005. The impact of GH replacement upon recurrence was evaluated after adjusting for possible confounding factors.
Results Forty‐one subjects received GH replacement. Nine of them did not have follow‐up imaging during GH therapy and were not included in the statistical analyses. The remaining 32 (22 males/10 females) received GH for a mean period of 6·3 ± 4·6 years (median 5·1, range 0·8–22); 21 started during childhood (13 of them continued after the achievement of final height with an adult dose) and 11 during adult life. The mean duration of their follow‐up (from surgery until last assessment) was 10·8 ± 9·2 years (range 1·9–40). Fifty‐three subjects had not received GH therapy (30 men/23 women). The mean duration of their follow‐up (from surgery until last assessment) was 8·3 ± 8·8 years (range 0·5–36). During the observation period, 4 patients treated with GH and 22 non‐GH treated ones developed tumour recurrence. After adjusting for sex, age at tumour diagnosis and type of tumour therapy (gross total removal, partial removal, surgery + irradiation), GH treatment was not a significant independent predictor of recurrence (P = 0·06; hazard ratio = 0·309). Similar results were obtained when the impact of GH replacement was assessed according to its duration (P = 0·18; hazard ratio = 0·991/month of treatment). None of the nine patients with insufficient imaging data for inclusion in the statistical analyses [5 men/4 women, 3 treated with GH during childhood/6 during adult life, mean duration of GH therapy 2·9 ± 2·4 years (median 1·8, range 0·4–7)] showed clinical features suggestive of recurrence during the period of GH replacement.
Conclusion Based on the data of the craniopharyngiomas database in Oxford, there is no evidence that GH replacement is associated with an increased risk of tumour recurrence. |
| doi_str_mv | 10.1111/j.1365-2265.2006.02508.x |
| format | Article |
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Background A significant number of patients with craniopharyngioma are GH deficient. The safety of GH replacement in these subjects has not been established.
Objective To assess the effect of GH replacement upon recurrence in patients with craniopharyngioma.
Patients and methods All the patients with craniopharyngioma followed‐up at the Departments of Endocrinology or Paediatrics in Oxford and treated or not with GH were studied retrospectively. These were recruited from the databases of the departments consisting of subjects diagnosed between January 1964 and July 2005. The impact of GH replacement upon recurrence was evaluated after adjusting for possible confounding factors.
Results Forty‐one subjects received GH replacement. Nine of them did not have follow‐up imaging during GH therapy and were not included in the statistical analyses. The remaining 32 (22 males/10 females) received GH for a mean period of 6·3 ± 4·6 years (median 5·1, range 0·8–22); 21 started during childhood (13 of them continued after the achievement of final height with an adult dose) and 11 during adult life. The mean duration of their follow‐up (from surgery until last assessment) was 10·8 ± 9·2 years (range 1·9–40). Fifty‐three subjects had not received GH therapy (30 men/23 women). The mean duration of their follow‐up (from surgery until last assessment) was 8·3 ± 8·8 years (range 0·5–36). During the observation period, 4 patients treated with GH and 22 non‐GH treated ones developed tumour recurrence. After adjusting for sex, age at tumour diagnosis and type of tumour therapy (gross total removal, partial removal, surgery + irradiation), GH treatment was not a significant independent predictor of recurrence (P = 0·06; hazard ratio = 0·309). Similar results were obtained when the impact of GH replacement was assessed according to its duration (P = 0·18; hazard ratio = 0·991/month of treatment). None of the nine patients with insufficient imaging data for inclusion in the statistical analyses [5 men/4 women, 3 treated with GH during childhood/6 during adult life, mean duration of GH therapy 2·9 ± 2·4 years (median 1·8, range 0·4–7)] showed clinical features suggestive of recurrence during the period of GH replacement.
Conclusion Based on the data of the craniopharyngiomas database in Oxford, there is no evidence that GH replacement is associated with an increased risk of tumour recurrence.</description><identifier>ISSN: 0300-0664</identifier><identifier>EISSN: 1365-2265</identifier><identifier>DOI: 10.1111/j.1365-2265.2006.02508.x</identifier><identifier>PMID: 16649976</identifier><identifier>CODEN: CLECAP</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>Adolescent ; Adult ; Biological and medical sciences ; Brain Neoplasms - pathology ; Child ; Child, Preschool ; Craniopharyngioma - pathology ; Endocrinopathies ; Female ; Follow-Up Studies ; Fundamental and applied biological sciences. Psychology ; Growth Hormone - therapeutic use ; Hormone Replacement Therapy ; Humans ; Infant ; Male ; Medical sciences ; Middle Aged ; Neoplasm Recurrence, Local - pathology ; Proportional Hazards Models ; Retrospective Studies ; Risk Factors ; Vertebrates: endocrinology</subject><ispartof>Clinical endocrinology (Oxford), 2006-05, Vol.64 (5), p.556-560</ispartof><rights>2006 INIST-CNRS</rights><rights>Copyright Blackwell Publishing May 2006</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4628-27c7bd1844b6281f168347ef88a257e3de374967a1d077c175559269e4fdda523</citedby><cites>FETCH-LOGICAL-c4628-27c7bd1844b6281f168347ef88a257e3de374967a1d077c175559269e4fdda523</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1365-2265.2006.02508.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1365-2265.2006.02508.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1416,27915,27916,45565,45566</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=17695813$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16649976$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Karavitaki, Niki</creatorcontrib><creatorcontrib>Warner, Justin T.</creatorcontrib><creatorcontrib>Marland, Anne</creatorcontrib><creatorcontrib>Shine, Brian</creatorcontrib><creatorcontrib>Ryan, Fiona</creatorcontrib><creatorcontrib>Arnold, Jayanth</creatorcontrib><creatorcontrib>Turner, Helen E.</creatorcontrib><creatorcontrib>Wass, John A. H.</creatorcontrib><title>GH replacement does not increase the risk of recurrence in patients with craniopharyngioma</title><title>Clinical endocrinology (Oxford)</title><addtitle>Clin Endocrinol (Oxf)</addtitle><description>Summary
Background A significant number of patients with craniopharyngioma are GH deficient. The safety of GH replacement in these subjects has not been established.
Objective To assess the effect of GH replacement upon recurrence in patients with craniopharyngioma.
Patients and methods All the patients with craniopharyngioma followed‐up at the Departments of Endocrinology or Paediatrics in Oxford and treated or not with GH were studied retrospectively. These were recruited from the databases of the departments consisting of subjects diagnosed between January 1964 and July 2005. The impact of GH replacement upon recurrence was evaluated after adjusting for possible confounding factors.
Results Forty‐one subjects received GH replacement. Nine of them did not have follow‐up imaging during GH therapy and were not included in the statistical analyses. The remaining 32 (22 males/10 females) received GH for a mean period of 6·3 ± 4·6 years (median 5·1, range 0·8–22); 21 started during childhood (13 of them continued after the achievement of final height with an adult dose) and 11 during adult life. The mean duration of their follow‐up (from surgery until last assessment) was 10·8 ± 9·2 years (range 1·9–40). Fifty‐three subjects had not received GH therapy (30 men/23 women). The mean duration of their follow‐up (from surgery until last assessment) was 8·3 ± 8·8 years (range 0·5–36). During the observation period, 4 patients treated with GH and 22 non‐GH treated ones developed tumour recurrence. After adjusting for sex, age at tumour diagnosis and type of tumour therapy (gross total removal, partial removal, surgery + irradiation), GH treatment was not a significant independent predictor of recurrence (P = 0·06; hazard ratio = 0·309). Similar results were obtained when the impact of GH replacement was assessed according to its duration (P = 0·18; hazard ratio = 0·991/month of treatment). None of the nine patients with insufficient imaging data for inclusion in the statistical analyses [5 men/4 women, 3 treated with GH during childhood/6 during adult life, mean duration of GH therapy 2·9 ± 2·4 years (median 1·8, range 0·4–7)] showed clinical features suggestive of recurrence during the period of GH replacement.
Conclusion Based on the data of the craniopharyngiomas database in Oxford, there is no evidence that GH replacement is associated with an increased risk of tumour recurrence.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>Brain Neoplasms - pathology</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Craniopharyngioma - pathology</subject><subject>Endocrinopathies</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Growth Hormone - therapeutic use</subject><subject>Hormone Replacement Therapy</subject><subject>Humans</subject><subject>Infant</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Neoplasm Recurrence, Local - pathology</subject><subject>Proportional Hazards Models</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Vertebrates: endocrinology</subject><issn>0300-0664</issn><issn>1365-2265</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2006</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkEtr3DAURkVpaSZp_0IRhXZnV5KthxddlCGdCYR0kzSQjdDI1x1NbMuVbDL595EzQwJdVRs97vkuVwchTElO0_q2y2kheMaY4DkjROSEcaLy_Ru0eCm8RQtSEJIRIcoTdBrjjhDCFZHv0QlNb1UlxQLdrdY4wNAaCx30I649RNz7EbveBjAR8LgFHFy8x75JpJ1CgN5CquPBjC5lIn5w4xbbYHrnh60Jj_0f5zvzAb1rTBvh43E_Qzc_z6-X6-zy1-pi-eMys6VgKmPSyk1NVVlu0pU2VKiilNAoZRiXUNRQyLIS0tCaSGmp5JxXTFRQNnVtOCvO0NdD3yH4vxPEUXcuWmhb04OfohayYqXgVQI__wPu_BT6NJumlVKUE0oSpA6QDT7GAI0eguvSpzQlepavd3p2rGfHepavn-XrfYp-OvafNh3Ur8Gj7QR8OQImWtM2yZh18ZWTouKKFon7fuAeXAuP_z2AXp5fzaeUzw55F0fYv-RNuE8yCsn17dVKr2_lnVS_qV4XT1fOrcE</recordid><startdate>200605</startdate><enddate>200605</enddate><creator>Karavitaki, Niki</creator><creator>Warner, Justin T.</creator><creator>Marland, Anne</creator><creator>Shine, Brian</creator><creator>Ryan, Fiona</creator><creator>Arnold, Jayanth</creator><creator>Turner, Helen E.</creator><creator>Wass, John A. H.</creator><general>Blackwell Publishing Ltd</general><general>Blackwell</general><general>Wiley Subscription Services, Inc</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>200605</creationdate><title>GH replacement does not increase the risk of recurrence in patients with craniopharyngioma</title><author>Karavitaki, Niki ; Warner, Justin T. ; Marland, Anne ; Shine, Brian ; Ryan, Fiona ; Arnold, Jayanth ; Turner, Helen E. ; Wass, John A. H.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4628-27c7bd1844b6281f168347ef88a257e3de374967a1d077c175559269e4fdda523</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2006</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Biological and medical sciences</topic><topic>Brain Neoplasms - pathology</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Craniopharyngioma - pathology</topic><topic>Endocrinopathies</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Growth Hormone - therapeutic use</topic><topic>Hormone Replacement Therapy</topic><topic>Humans</topic><topic>Infant</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Neoplasm Recurrence, Local - pathology</topic><topic>Proportional Hazards Models</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Vertebrates: endocrinology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Karavitaki, Niki</creatorcontrib><creatorcontrib>Warner, Justin T.</creatorcontrib><creatorcontrib>Marland, Anne</creatorcontrib><creatorcontrib>Shine, Brian</creatorcontrib><creatorcontrib>Ryan, Fiona</creatorcontrib><creatorcontrib>Arnold, Jayanth</creatorcontrib><creatorcontrib>Turner, Helen E.</creatorcontrib><creatorcontrib>Wass, John A. H.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical endocrinology (Oxford)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Karavitaki, Niki</au><au>Warner, Justin T.</au><au>Marland, Anne</au><au>Shine, Brian</au><au>Ryan, Fiona</au><au>Arnold, Jayanth</au><au>Turner, Helen E.</au><au>Wass, John A. H.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>GH replacement does not increase the risk of recurrence in patients with craniopharyngioma</atitle><jtitle>Clinical endocrinology (Oxford)</jtitle><addtitle>Clin Endocrinol (Oxf)</addtitle><date>2006-05</date><risdate>2006</risdate><volume>64</volume><issue>5</issue><spage>556</spage><epage>560</epage><pages>556-560</pages><issn>0300-0664</issn><eissn>1365-2265</eissn><coden>CLECAP</coden><abstract>Summary
Background A significant number of patients with craniopharyngioma are GH deficient. The safety of GH replacement in these subjects has not been established.
Objective To assess the effect of GH replacement upon recurrence in patients with craniopharyngioma.
Patients and methods All the patients with craniopharyngioma followed‐up at the Departments of Endocrinology or Paediatrics in Oxford and treated or not with GH were studied retrospectively. These were recruited from the databases of the departments consisting of subjects diagnosed between January 1964 and July 2005. The impact of GH replacement upon recurrence was evaluated after adjusting for possible confounding factors.
Results Forty‐one subjects received GH replacement. Nine of them did not have follow‐up imaging during GH therapy and were not included in the statistical analyses. The remaining 32 (22 males/10 females) received GH for a mean period of 6·3 ± 4·6 years (median 5·1, range 0·8–22); 21 started during childhood (13 of them continued after the achievement of final height with an adult dose) and 11 during adult life. The mean duration of their follow‐up (from surgery until last assessment) was 10·8 ± 9·2 years (range 1·9–40). Fifty‐three subjects had not received GH therapy (30 men/23 women). The mean duration of their follow‐up (from surgery until last assessment) was 8·3 ± 8·8 years (range 0·5–36). During the observation period, 4 patients treated with GH and 22 non‐GH treated ones developed tumour recurrence. After adjusting for sex, age at tumour diagnosis and type of tumour therapy (gross total removal, partial removal, surgery + irradiation), GH treatment was not a significant independent predictor of recurrence (P = 0·06; hazard ratio = 0·309). Similar results were obtained when the impact of GH replacement was assessed according to its duration (P = 0·18; hazard ratio = 0·991/month of treatment). None of the nine patients with insufficient imaging data for inclusion in the statistical analyses [5 men/4 women, 3 treated with GH during childhood/6 during adult life, mean duration of GH therapy 2·9 ± 2·4 years (median 1·8, range 0·4–7)] showed clinical features suggestive of recurrence during the period of GH replacement.
Conclusion Based on the data of the craniopharyngiomas database in Oxford, there is no evidence that GH replacement is associated with an increased risk of tumour recurrence.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>16649976</pmid><doi>10.1111/j.1365-2265.2006.02508.x</doi><tpages>5</tpages></addata></record> |
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| subjects | Adolescent Adult Biological and medical sciences Brain Neoplasms - pathology Child Child, Preschool Craniopharyngioma - pathology Endocrinopathies Female Follow-Up Studies Fundamental and applied biological sciences. Psychology Growth Hormone - therapeutic use Hormone Replacement Therapy Humans Infant Male Medical sciences Middle Aged Neoplasm Recurrence, Local - pathology Proportional Hazards Models Retrospective Studies Risk Factors Vertebrates: endocrinology |
| title | GH replacement does not increase the risk of recurrence in patients with craniopharyngioma |
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