Insights into body composition in pediatric craniopharyngioma patients after surgical treatment.

Background: Craniopharyngioma, a benign suprasellar tumor, is typically treated surgically with radiotherapy when indicated. Due to its proximity to the pituitary-hypothalamic region, patients often experience endocrine deficiencies.

Objective: To explore the body composition components and their interaction with metabolic syndrome (MetS) components in pediatric craniopharyngioma patients after surgery.

Design: Longitudinal single-center real-life study of 33 pediatric patients who were diagnosed with craniopharyngioma for which they underwent surgery between 2012 and 2024.

Methods: Electronic medical reports were reviewed for clinical data, and a bioimpedance analysis (BIA) database was searched for body composition. Fifty-four BIA reports of 21 patients with craniopharyngioma were analyzed. The latest reported values were compared to those of 63 sex- and age-matched healthy controls. Changes in anthropometric measurements and indices of muscle and adiposity were assessed by linear mixed models.

Results: Patients with craniopharyngioma exhibited higher adiposity compared to controls, with significantly elevated total body fat percentage (FATP; p < 0.001), trunk-to-total body FATP ratio (p = 0.012), and lower muscle-to-fat ratio (MFR) z-scores (p < 0.001). The appendicular skeletal muscle mass (ASMM) z-scores were similar. A sex- and age-adjusted model revealed that the diagnosis of MetS components was positively associated with FATP [odds ratio = 1.13, confidence interval (1.04, 1.23), p = 0.006]. Patients with craniopharyngioma demonstrated an increase in ASMM z-score over time (β = 0.14, SE = 0.04, p = 0.002) together with a decline in sex- and age-adjusted FATP (β = -0.99, SE = 0.41, p = 0.018).

Conclusion: Despite struggling with obesity and hormonal deficiencies, survivors of craniopharyngioma showed favorable changes in body composition with appropriate medical interventions. Strategies to prevent metabolic complications and tailored hormone replacement therapies are essential for managing metabolic decline.