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Development of a novel score to predict probability of growth without growth hormone after resection of paediatric craniopharyngiomas: relative to tumour growth pattern

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Abstract

Objective

Some patients with paediatric craniopharyngiomas (PCs) showed normal growth despite growth hormone deficiency, which is known as growth without GH (GWGH); however, its mechanism remains unclear. We aimed to develop a novel clinical score to predict the probability of GWGH in PCs.

Methods

A total of 708 PC patients were prospectively enrolled from six hospitals, among which 431 patients were finally included. Data from four of the six hospitals (n = 325) were used to develop the innovative clinical score (ICS), which was further validated using the data from the other two hospitals (n = 106). To establish and validate the ICS, sequential logistic regression was used to analyse the clinical characteristics including tumour growth pattern and tumour size and so on. Furthermore, C-statistic was employed to calibrate the discriminatory ability of the established clinical score, while a calibration plot was adopted for further assessment.

Results

The overall incidence of GWGH was 16.9% (73/431). The ICS ranged from 2 to 23, with an optimism-corrected C-statistic of 0.820, Furthermore, the optimism-corrected C-statistic of external validation was 0.835, indicating good discriminatory power and robustness of the clinical score. Additionally, no apparent overestimation or underestimation was observed in the calibration plots, which showed excellent calibration power of the clinical score.

Conclusions

Based on tumour growth patterns and PC patients’ clinical characteristics, individualized surgical strategies were promising to achieve long-term effective management of PC patients. The ICS is valuable for the evaluation of probability of developing postoperative GWGH.

Clinical trial registration

ClinicalTrials.gov ID: NCT00949156.

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Acknowledgements

The authors thank Duan Chongyang, MD, Xu Hai-yan, RN, Qiu xiao-yu, RN, Wang Hai, MD, and Fan Jun, MD for the collection of data and care of patients enrolled in this study.

Funding

This research received grant from four fund projects in the public, including Science and Technology Program of Guangdong (No. 2017A020215048) and the Natural Science Foundation of Guangdong Province (No. 2019A1515012140), and Clinical Research Startup Program of Southern Medical University by High-level University Construction Funding of Guangdong Provincial Department of Education (LC2016YM001).

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Author notes

  1. J.X. Peng, L. Yang, G.L. Huang, Y. Liu and S.C. Zhang contributes equally to this work.

Authors and Affiliations

  1. Department of Neurosurgery, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, Guangdong, China

    J. X. Peng, L. Yang, G. L. Huang, Y. Liu, S. C. Zhang, J. Pan & S. T. Qi

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  1. J. X. Peng
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Correspondence to J. X. Peng, J. Pan or S. T. Qi.

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Conflict of interest

We declare that we have no other financial and personal relationships with other people or organizations that can inappropriately influence our work, there is no professional or other personal interest of any nature or kind in any product, service and/or company that could be construed as influencing the position presented in, or the review of, the manuscript entitled “Development of a Novel Score to Predict Probability of Growth without Growth Hormone after Resection of Pediatric Craniopharyngiomas: Relative to Tumor Growth Pattern”. All the work is original, Neither the entire paper nor any part of its content has been published, submitted or accepted elsewhere, which has been approved by all authors.

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All procedures performed in studies involving human participants were approved by the ethics committee at the Nanfang Hospital, Southern Medical University (SMU) and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Peng, J.X., Yang, L., Huang, G.L. et al. Development of a novel score to predict probability of growth without growth hormone after resection of paediatric craniopharyngiomas: relative to tumour growth pattern. J Endocrinol Invest 43, 737–747 (2020). https://doi.org/10.1007/s40618-019-01154-y

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