Clinical and prognostic implications of pituitary macroadenomas (pituitary neuroendocrine tumors (PitNets)) grading: a monocentric experience
Authors' conclusion
Invasive and not-proliferating PitNets (2a) were more frequently associated to impaired pituitary function/visual field before and after surgery. Less proliferating tumors (1a and 2a) were more responsive to surgery. Ki-67 correlated to disease persistence in FPA, while adiuvant radiotherapy was more needed among invasive tumors. Thus, among ≥ 1 cm PitNets, tumor invasion seems to impact on clinico-biochemical outcomes, while Ki-67 proliferation index influences surgical outcomes.
Study context
- Population
- Consecutive patients with functioning (FPA) or non-functioning pituitary macroadenomas (NFPA), operated by the same neurosurgeon 2015–2020, Endocrine Unit of Messina University Hospital; 51 M, 50.5±14.7 yrs
- Participants
- 88 patients
- Exposure
- Trouillas grades 1a, 1b, 2a and 2b
- Outcome
- Distribution of Trouillas grades
Methodological detailsmonocentric, consecutive patients, Follow-up median 3 ± 1.5 yrs; outcomes at 6 months after surgery and at last follow-up
- Monocentric
- Consecutive patients
- Follow-up median 3 ± 1.5 yrs; outcomes at 6 months after surgery and at last follow-up
Main finding
As reported in the abstract
Observational data: associations, not effects.
Further findings
Features at diagnosis
- Panhypopituitarism and visual field alterations more frequent among 2a tumors
- GH-omas significantly prevalent among 1a tumors, NFPA among 2a
Response to single surgery
- 1a and 2a PitNets had a better response to single surgery
- P < 0.01
Cyberknife stereotactic radiotherapy
- Needed more frequently in 2a and 2b tumors
Panhypopituitarism/visual field alterations after surgery
- More frequent among 2a PitNets even after surgery
Predictors of persistence/remnant
- Ki-67 positively associated with persistent disease in FPA
- Radiological invasion associated with remnant presence among NFPA
Original publication
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