Hypothalamic-Stratified Nursing Pathway for Pediatric Craniopharyngioma

Sichuan University

Status

Completed

Conditions

Craniopharyngioma

Growth Hormone Deficiency (GHD)

Study type

Observational

Funder types

Other

Identifiers

NCT07342686

WestChinaH-HX-2025-07

Details and patient eligibility

About

The goal of this multicenter retrospective cohort study is to determine whether MRI-graded hypothalamic injury severity predicts growth-hormone deficiency (GHD) and neuropsychological morbidity in 500 children and adolescents (≤ 18 y) who underwent craniopharyngioma resection at six Chinese pediatric centers between 2013 and 2023 and were followed ≥ 2 years. The main questions it aims to answer are:

Does increasing hypothalamic injury grade (Grade 0 = uninvolved, Grade 1 = mild compression, Grade 2 = significant invasion) independently correlate with higher incidence of GHD, lower IGF-1 levels, greater height SDS decline, and increased need for recombinant human GH therapy?
Is higher injury grade associated with worse neuropsychological outcomes-lower IQ, impaired executive function, emotional disorders, and obesity-after adjustment for age, tumor size, and extent of resection?

Researchers compared the three injury-grade groups to quantify endocrine and neuro-behavioral outcomes and to catalog differentiated nursing needs (growth monitoring frequency, dietary-behavioral plans, psychological support intensity, comorbidity surveillance). Participants underwent pre- and post-operative MRI grading by blinded neuroradiologists, standardized endocrine stimulation tests, annual neuropsychological testing (WISC-IV, BRIEF, CBCL), and detailed nursing-documentation review; all data were analyzed with Spearman correlation, ANOVA, and multivariable logistic regression.

Enrollment

500 patients

Sex

All

Ages

Under 18 years old

Volunteers

No Healthy Volunteers

Inclusion criteria

Age ≤18 years at the time of craniopharyngioma resection;
Pathologically confirmed craniopharyngioma;
Postoperative follow-up duration ≥2 years;
Complete preoperative and postoperative MRI data, endocrine test results, neuropsychological assessment records, and nursing documentation;
No preoperative GHD, neuropsychological disorders, or other systemic diseases affecting growth or neurodevelopment.

Exclusion criteria

Preoperative diagnosis of GHD, cognitive impairment, or emotional disorders;
Concurrent intracranial tumors or systemic diseases (e.g., congenital growth hormone deficiency, Down syndrome);
Loss to follow-up or incomplete clinical data;
Tumor recurrence requiring reoperation during follow-up.