Pituitary function before and after surgery for nonfunctioning pituitary adenomas—data from the Swedish Pituitary Register
Authors' conclusion
Adrenocorticotrophic hormone deficiency increased significantly at 1 year postoperatively. Even though not significant, some patients recovered from or developed new deficiency between 1 and 5 years postoperatively. This pattern was seen in all axes. Our study emphasizes that continuous individual evaluations are needed during longer follow-up of patients operated for NFPA.
Study context
- Population
- Patients with nonfunctioning pituitary adenomas (NFPA) diagnosed 1991–2014 undergoing transsphenoidal surgery, Swedish Pituitary Register428 with HPA data
- Participants
- 838 patients
- Exposure
- Pituitary function before vs after transsphenoidal surgery
- Outcome
- Anterior pituitary function, with emphasis on the HPA axis (ACTH deficiency)
- Follow-up
- Before and up to 5 years after surgery
Methodological detailsSwedish Pituitary Register, reoperated or irradiated patients excluded
- Swedish Pituitary Register
- Reoperated or irradiated patients excluded
Main finding
As reported in the abstract
ACTH deficiency (patients with preoperative, 1-year and 5-year HPA data) · preoperative, 1 year and 5 years postoperative
- ACTH-deficient preoperatively
- 125 (29%)
- Recovered ACTH function at 1 year
- 26% (32/125)
- New ACTH deficiency at 1 year
- 23% (70/303)
- ACTH-deficient at 1 year (vs preoperatively)
- 163 (38%); P < .001
- ACTH-deficient at 5 years (no further increase)
- 36%; P = .096
Observational data: associations, not effects.
Further findings
Preoperative deficiencies
- ACTH deficiency
- 31% (236/755)
- TSH deficiency
- 39% (300/769)
- LH/FSH deficiency
- 51% (378/742)
- GH deficiency
- 28% (170/604)
Preoperative tumour volume
- Median tumour volume
- 5.0 (2.4-9.0) cm³
TSH and LH/FSH axes recovery and new deficiency · 1 year postoperatively
- TSH recovery
- 14% (33/241)
- LH/FSH recovery
- 15% (46/310)
- New TSH deficiency
- 22% (88/403)
- New LH/FSH deficiency
- 29% (83/288)
Original publication
Pituitary function before and after surgery for nonfunctioning pituitary adenomas—data from the Swedish Pituitary Register. Eur J Endocrinol. Published 8 August 2023. doi:10.
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