International Journal of Biomedicine. 2018;8(3):197-200.
Originally published September 15, 2018
The aim of this study was to determine the clinical and diagnostic markers of tumor aggressiveness that are predictive of tumor recurrence in patients with non-functioning pituitary adenoma (NFPA) and growth hormone deficiency (GHD).
A total of 87 patients with NFPA and GHD were enrolled in the study, including 31 patients after transsphenoidal hypophysectomy (postoperative follow-up from 1 to 3 years). The mean age of patients was 32.2±2.5 years. The search for clinical and diagnostic markers of NFPA aggressiveness that are predictive of tumor recurrence after transsphenoidal hypophysectomy revealed a direct correlation with such risk factors as the young age of the patient, large tumor size, asymmetry and deformation of the pituitary gland, signs of tumor invasion into surrounding tissues, arteries, and cavernous sinus, panhypopituitarism, and the small-cell and/or dark-cell chromophobic adenomas. Preliminary data as well as a number of studies, confirm that predictors of pituitary tumor recurrence and markers of persistent disease activity still have to be identified in order to improve the long-term management of NFPA.
- Ntali G, Wass JA. Epidemiology, clinical presentation and diagnosis of non-functioning pituitary adenomas. Pituitary. 2018;21(2):111-118. doi: 10.1007/s11102-018-0869-3. PubMed
- Chanson P, Raverot G, Castinetti F, Cortet-Rudelli C, Galland F, Salenave S; French Endocrinology Society non-functioning pituitary adenoma work-group. Management of clinically non-functioning pituitary adenoma. Ann Endocrinol (Paris). 2015;76(3):239-47. doi: 10.1016/j.ando.2015.04.002. PubMed
- Wichers-Rother M, Hoven S, Kristof RA, Bliesener N, Stoffel-Wagner B. Non-functioning pituitary adenomas: endocrinological and clinical outcome after transsphenoidal and transcranial surgery. Exp Clin Endocrinol Diabetes. 2004;112(6):323-7. PubMed
- Khalimova ZYu, Kholova DSh, Urmanova YuM, Alieva DA, Alimukhamedova GA, Nasirova KhK. Reproductive Function in Patients with Non-functioning Pituitary Adenoma According to the Register of the Republic of Uzbekistan. International Journal of Biomedicine.2016,6(2):133-135.
- Roelfsema F, Biermasz NR, Pereira AM. Clinical factors involved in the recurrence of pituitary adenomas after surgical remission: a structured review and meta-analysis. Pituitary 2012;15(1):71-83. doi: 10.1007/s11102-011-0347-7. PubMed
- Saeger W. Pituitary tumors: prognostic indicators. Endocrine 2005;28(1): 57-66. PubMed
- Noh TW, Jeong HJ, Lee MK, Kim TS, Kim SH, Lee EJ. Predicting recurrence of nonfunctioning pituitary adenomas. J Clin Endocrinol Metab. 2009;94(11):4406-13. doi: 10.1210/jc.2009-0471. PubMed
- Šteňo A, Bocko J, Rychlý B, Chorváth M, Celec P, Fabian M, et al. Nonfunctioning pituitary adenomas: association of Ki-67 and HMGA-1 labeling indices with residual tumor growth. Acta Neurochir (Wien). 2014; 156(3):451-61; discussion 461. doi: 10.1007/s00701-014-1993-0. PubMed
- Lee MH, Lee JH, Seol HJ, Lee JI, Kim JH, Kong DS, Nam DH. Clinical Concerns about Recurrence of Non-Functioning Pituitary Adenoma. Brain Tumor Res Treat. 2016;4(1):1-7. doi: 10.14791/btrt.2016.4.1.1. PubMed
- Chang EF, Zada G, Kim S, Lamborn KR, Quinones-Hinojosa A, Tyrrell JB, et al. Long-term recurrence and mortality after surgery and adjuvant radiotherapy for nonfunctional pituitary adenomas. J Neurosurg. 2008; 108(4):736-45. doi: 10.3171/JNS/2008/108/4/0736. PubMed
- Losa M, Mortini P, Barzaghi R, Ribotto P, Terreni MR, Marzoli SB, et al. Early results of surgery in patients with nonfunctioning pituitary adenoma and analysis of the risk of tumor recurrence. J Neurosurg. 2008; 108(3):525-32. doi: 10.3171/JNS/2008/108/3/0525. PubMed
- Nomikos P, Ladar C, Fahlbusch R, Buchfelder M. Impact of primary surgery on pituitary function in patients with non-functioning pituitary adenomas -- a study on 721 patients. Acta Neurochir (Wien). 2004;146(1):27-35. PubMed
- Dekkers OM, Pereira AM, Roelfsema F, Voormolen JH, Neelis KJ, Schroijen MA, et al. Observation alone after transsphenoidal surgery for nonfunctioning pituitary macroadenoma. J Clin Endocrinol Metab. 2006;91(5):1796-801. PubMed
- O’Sullivan EP, Woods C, Glynn N, Behan LA, Crowley R, O’Kelly P, et al. The natural history of surgically treated but radiotherapynaive nonfunctioning pituitary adenomas. Clin Endocrinol (Oxf). 2009;71(5):709-14. doi: 10.1111/j.1365-2265.2009.03583.x. PubMed
- Greenman Y, Ouaknine G, Veshchev I, Reider G, II, Segev Y, Stern N. Postoperative surveillance of clinically nonfunctioning pituitary macroadenomas: markers of tumour quiescence and regrowth. Clin Endocrinol (Oxf). 2003;58(6):763-9. PubMed
- van den Bergh AC, van den Berg G, Schoorl MA, Sluiter WJ,van der Vliet AM, Hoving EW, et al. Immediate postoperative radiotherapy in residual nonfunctioning pituitary adenoma: beneficial effect on local control without additional negative impact on pituitary function and life expectancy. Int J Radiat Oncol Biol Phys. 2007;67(3):863-9. PubMed
Received July 9, 2018.
Accepted August 18, 2018.
©2018 International Medical Research and Development Corporation.