Natural history of nonfunctioning pituitary microadenomas: a systematic review and individual participant data meta-analysis
Authors' conclusion
These data suggest that routine follow-up of micro-NFPAs can be reduced significantly and that available guidelines should be revisited.
Study context
- Population
- Patients with conservatively treated micro-NFPAs with at least 1 follow-up MRI6 studies' individual participant data (IPD)
- Participants
- 647 patients
- Outcome
- Need for surgical intervention and risk of developing new endocrinopathies during follow-up
Methodological details2-step approach
- 2-step approach
Pooled result
As reported in the abstract
Incidence per 100 person-years
- Overall probability of surgery
- 0.2/100 person-years (PYs) (95% CI 0.0-0.4; I2 = 28%)
- Surgery due to visual impairment
- 0.1/100 PYs (95% CI 0.0-0.2; I2 = 0%)
- New endocrinopathy
- 1.0/100 PYs (95% CI 0.4-1.6; I2 = 0%)
- Surgery risks independent of baseline tumor size (≥6 or <6 mm), sex, or age
- P values >.40
Further pooled results
Classical meta-analysis
- Supported the IPD results (7 studies, N = 1089)
Original publication
Natural history of nonfunctioning pituitary microadenomas: a systematic review and individual participant data meta-analysis. Eur J Endocrinol. Published 22 September 2025. doi:10.
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