A COMPARISON OF CHILDREN WITH SUPRASELLAR GERM-CELL TUMORS AND CRANIOPHARYNGIOMAS - FINAL HEIGHT, WEIGHT, ENDOCRINE, AND VISUAL SEQUELAE AFTER TREATMENT

BACKGROUND Although treatment results of craniopharyngiomas and germ c ell tumors in children have been reported extensively, the relationshi p between various posttreatment sequelae and the nature of the tumor i s not well understood. METHODS From 1968-94, 47 children with 23 supra sellar germ cell tumors and 24 craniopharyngiomas were treated at Gunm a University Hospital, Japan. Forty survivors were assessed with regar d to Karnofsky scores, visual scores, final height, final weight, and other endocrine sequelae as long-term functional prognostic indicators . RESULTS Kaplan-Meier life-table estimates and Karnofsky scores were not significantly different between the two histologic groups. The vis ual function of survivors did not differ significantly at diagnosis. H owever, the final visual function following treatment in the germ cell tumor group was better than in the craniopharyngioma group (p < 0.05) . Antidiuretic hormone secretion was significantly impaired at diagnos is in the germ cell tumor group (p < 0.0001). However, there was only a marginally significant difference in posttreatment persistent diabet es insipidus. Craniopharyngioma children were shorter and more obese a t diagnosis (p < 0.02), and became much more obese than germinoma chil dren with the same hormone therapy (p < 0.003), although the height di fference became insignificant following growth hormone treatment. CONC LUSIONS Children with craniopharyngiomas tended to have more visual di sturbances, increased dwarfism and obesity, and less diabetes insipidu s than patients with germ cell tumors despite adequate therapy. The me thod of quantifying visual function may in itself be useful.