Gender differences in surgical outcomes and predictors of long term endocrine and metabolic morbidity in adults with craniopharyngioma
Authors' conclusion
Despite curative-intended surgery adult survivors with CP experience substantial endocrine and metabolic morbidity, driven by tumor topography, surgical route and adjuvant radiotherapy.
Study context
- Population
- Adults (≥ 18 y) with histologically confirmed craniopharyngioma treated surgically at Ramón y Cajal University Hospital (Spain) or University of South Florida (USA), ≥ 1 year postoperative follow-upmedian follow-up 6 years
- Participants
- 51 adults
- Exposure
- Men vs women; predictors of long-term endocrine-metabolic morbidity
- Menn = 32
- Womenn = 19reference
- Outcome
- Characteristics at diagnosis by sex
- Follow-up
- Diagnosis
Methodological detailsbi-institutional
- Bi-institutional
Main finding
As reported in the abstract
- Men vs Women: P = 0.038
- Men vs Women: P = 0.030
- Men vs Women: P = 0.043
Observational data: associations, not effects.
Further findings
Surgical approach and resection
- Transsphenoidal surgery
- 71%
- Gross total resection
- 63%
Persistent visual loss: predictor
- Radiotherapy, only independent predictor (OR)
- 1.62; p = 0.002
New pituitary deficits · last follow-up
- ≥ 1 new pituitary deficit
- 44%
- New TSH deficit
- 24%
- New ACTH deficit
- 30%
- Craniotomy independently increased number of altered axes
- P = 0.001
- Male sex predicted new-onset TSH deficiency (OR)
- 1.3 [1.1-2.1], p = 0.003
Obesity and body mass index (BMI) · after surgery
- Obesity prevalence
- 71%
- Suprasellar location predicted higher final BMI (OR)
- 5.3; p = 0.014
Metabolic comorbidity vs registry (standardized prevalence ratios (SPR))
- Diabetes SPR, Spain
- 3.64
- Diabetes SPR, USA
- 2.53
- Dyslipidemia higher in Spain
- 70%
- Hypertension SPRs neutral
- Radiotherapy, residual tumor and BMI independently predicted metabolic outcomes
- Registry-matched standardized prevalence ratios
Original publication
Gender differences in surgical outcomes and predictors of long term endocrine and metabolic morbidity in adults with craniopharyngioma. Pituitary. Published 20 February 2026. doi:10.
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