Outcome of non-functioning ACTH pituitary tumors: silent does not mean indolent
Main findingResult — go to the resultRisk of progression/recurrence 7-fold-time higherAuthors' conclusion
The five-tiered clinicopathological classification contribute to predict the risk of recurrence of operated siACTH tumors. Noteworthy, non-invasive and non-proliferative siACTH exhibit a less favorable outcomes than their siLH/FSH counterparts, which should prompt for a personalized follow up.
Study context
- Population
- Patients with pituitary tumors operated in one tertiary center, 2008–2022865 pituitary tumors (PT) operated
- Participants
- 29 / 25 / 143
- Exposure
- siACTH vs macroCD and siLH/FSH; siACTH grades per five-tiered clinicopathological classification
- siACTHn = 29
- macroCDn = 25
- siLH/FSHn = 143reference
- Outcome
- Progression-free survival after surgery by five-tiered clinicopathological grade (invasion 1/2; proliferation a/b)
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
Risk of progression/recurrence
7-fold-time higher
P = 0.06
- siACTH grade 1a
- 15 (51.7%)
- siACTH grade 2a
- 11 (37.9%)
- siACTH grade 2b
- 3 (10.3%)
Observational data: associations, not effects.
Further findings
| Outcome | Risk of progression | P value |
|---|---|---|
| Progression risk in grade 1a tumorsGrade 1a siACTH vs Grade 1a siLH/FSH | 5.7-fold-higher | P = 0.02 |
Progression risk in grade 1a tumors
- Repartition of tumor grades similar between the three subgroups
Preoperative ACTH levels
- Higher ACTH levels vs siLH/FSH may help to preoperatively identify siACTH
Original publication
Outcome of non-functioning ACTH pituitary tumors: silent does not mean indolent. Pituitary. Published 12 July 2024. doi:10.
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