CP-03. Sex-associated differences in disease progression and functional outcomes of adamantinomatous craniopharyngioma in prepubescent patients
Bibliographic record
Abstract
Abstract Background Adamantinomatous craniopharyngioma (ACP) comprises 5-11% of pediatric intracranial tumors and is associated with poor quality of life. In general, cancer outcome studies indicate that females have higher survival rates and better treatment responses than males. Leading theories focus on sex-related genetic/molecular differences versus sex hormone differences as primary contributors to the different outcomes. Here, we investigated sex-associated differences in survival and functional outcomes of prepubescent patients with ACP, aiming to study the role of biological sex in the absence of hormonal effects. Methods Sixty-four patients diagnosed with ACP under 7 years of age were retrospectively identified from the Advancing Treatment for Pediatric Craniopharyngioma (ATPC) and the Children’s Hospital Colorado databases. A Cox regression model was used to evaluate time to recurrence/progression. A linear regression model was used to evaluate functional outcomes compared to pre-treatment baseline using a modified Craniopharyngioma Clinical Status Scale (CCSS). Patient age and length of follow-up were included as covariates. Results We found that sex is a statistically significant predictor of disease progression (p = 0.0183, power = 0.999), with males demonstrating a 57.4% lower risk of progression (95% CI [13.5%, 79.0%]). In contrast, patient age and follow-up duration did not significantly affect the hazard of progression. There was no statistically significant difference in neurological, visual, pituitary, or hypothalamic functional outcomes between males and females. Conclusions Our study finds that in prepubescent ACP patients, males have a lower risk of disease progression than females, although the functional outcomes are equivalent. With an underdeveloped hypothalamic-pituitary-gonadal axis in prepubertal patients, the observed sex difference is likely attributed to factors such as genetic and molecular differences other than hormonal effects. This study highlights the need to identify variables impacting ACP disease course and advocates for personalized treatment strategies to improve patient outcomes and quality of life.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".