Physiologic Growth Hormone–Replacement Therapy and Craniopharyngioma Recurrence in Pediatric Patients: A Meta-Analysis

摘要

Objective A systematic review and meta-analysis were conducted to examine the effect of growth hormone–replacement therapy (GHRT) on the recurrence of craniopharyngioma in children. Methods PubMed, Embase, and Cochrane databases were searched through April 2017 for studies that evaluated the effect of GHRT on the recurrence of pediatric craniopharyngioma. Pooled effect estimates were calculated with fixed- and random-effects models. Results Ten studies ( n ?= 3487 patients) met?all inclusion criteria, including 2 retrospective cohorts and 8 case series. Overall, 3436 pediatric patients were treated with GHRT after surgery and 51 were not. Using the fixed effect model, we found that the overall craniopharyngioma recurrence rate was lower among children who were treated by GHRT (10.9%; 95% confidence interval 9.80%–12.1%; I 2 ?= 89.1%; P for heterogeneity n ?= 10 groups) compared with those who were not (35.2%; 95% confidence interval 23.1%–49.6%; I 2 ?= 61.7%; P for heterogeneity?= 0.11; n ?= 3); the P value comparing the 2 groups was P P P ?= 0.03), or studies with a lower quality rating ( P ?= 0.01). Using the random-effects model, we found that the results were not materially different except for when stratifying by GHRT, impact factor, or study quality; this led to nonsignificant differences. Both Begg's rank correlation test ( P ?= 0.7) and Egger's linear regression test ( P ?= 0.06) indicated no publication bias. Conclusions This meta-analysis demonstrated a lower recurrence rate of craniopharyngioma among children treated with GHRT than those who were not.