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Purpose <p>Adult-onset craniopharyngiomas (CPs) often present after diagnostic delays, yet the prognostic relevance of duration of history (DOH) and specific clinical manifestations remains unexplored.</p> Method <p>Data of patients aged &gt; 18 years at CP diagnosis between June 2012 and October 2024 at the First Affiliated Hospital of Nanchang University were retrospectively reviewed. Associations between DOH, specific symptoms, and tumor characteristics at diagnosis, as well as long-term outcomes, were systematically analyzed.</p> Results <p>Among 151 patients (median follow-up, 71 months) in our cohort, the median DOH was 5 months and showed no significant correlation with tumor volume at diagnosis, hypothalamic involvement, extent of resection, or long-term prognosis including mortality, recurrence, and hypothalamic syndrome at last visit. Patients with amenorrhea/sexual dysfunction in history demonstrated significantly longer DOH (<i>p</i> &lt; 0.001), while those with neurological deficits (<i>p</i> = 0.043) or hydrocephalus (<i>p</i> = 0.044) were associated with shorter DOH. Neurological deficits in history was associated with larger tumor volume at diagnosis (<i>p</i> = 0.016). Headache presented as the first symptom was linked to significantly shorter DOH (<i>p</i> = 0.003) and neurological deficits as the first symptom was associated with worse progression-free survival (<i>p</i> = 0.047).</p> Conclusion <p>Diagnostic delays are common in adult-onset CP patients but appear unrelated to tumor burden or long-term prognosis. Neurological deficits in history or as the first symptom should trigger prompt diagnostic workup and more rigorous follow-up, while prolonged diagnostic delays in those with endocrine symptoms underscore the need for heightened awareness among clinicians to expedite referral and diagnosis.</p>

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History before diagnosis in adult-onset craniopharyngioma: associations with initial presentation and long-term prognosis: a retrospective cohort study of 151 patients

  • 期刊论文

  • 发表日期：

    2026年1月5日

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  • Jie Wu,
  • Furong Liang,
  • Zhicheng Ye,
  • Laisheng Pan,
  • Bowen Wu,
  • Xiao Wu,
  • Hai Luo,
  • Shenhao Xie,
  • Bin Tang,
  • Chunming Xu,
  • Tao Hong

摘要

Purpose

Adult-onset craniopharyngiomas (CPs) often present after diagnostic delays, yet the prognostic relevance of duration of history (DOH) and specific clinical manifestations remains unexplored.

Method

Data of patients aged > 18 years at CP diagnosis between June 2012 and October 2024 at the First Affiliated Hospital of Nanchang University were retrospectively reviewed. Associations between DOH, specific symptoms, and tumor characteristics at diagnosis, as well as long-term outcomes, were systematically analyzed.

Results

Among 151 patients (median follow-up, 71 months) in our cohort, the median DOH was 5 months and showed no significant correlation with tumor volume at diagnosis, hypothalamic involvement, extent of resection, or long-term prognosis including mortality, recurrence, and hypothalamic syndrome at last visit. Patients with amenorrhea/sexual dysfunction in history demonstrated significantly longer DOH (p < 0.001), while those with neurological deficits (p = 0.043) or hydrocephalus (p = 0.044) were associated with shorter DOH. Neurological deficits in history was associated with larger tumor volume at diagnosis (p = 0.016). Headache presented as the first symptom was linked to significantly shorter DOH (p = 0.003) and neurological deficits as the first symptom was associated with worse progression-free survival (p = 0.047).

Conclusion

Diagnostic delays are common in adult-onset CP patients but appear unrelated to tumor burden or long-term prognosis. Neurological deficits in history or as the first symptom should trigger prompt diagnostic workup and more rigorous follow-up, while prolonged diagnostic delays in those with endocrine symptoms underscore the need for heightened awareness among clinicians to expedite referral and diagnosis.