Predictors of pituitary tumour behaviour: an analysis from long-term follow-up in 2 tertiary centres
Authors' conclusion
Proliferative markers, including Ki67 and mitotic count, but not p53, are important in predicting the development of aggressive pituitary tumour behaviour.
Study context
- Population
- Adults undergoing pituitary surgery at Oxford University and St Vincent's Hospitals, 1989–2016, with ≥12 months of clinical data; age 56 (IQR 41–67) years, 54% male; 65% clinically nonfunctioning
- Participants
- 386 adults
- Outcome
- Tumour recurrence (radiological or reintervention ≥12 months postoperatively) and/or aggressive behaviour (≥4 interventions and/or invasive tumour with recurrence/reintervention between 12 and 24 months postoperatively)
- Follow-up
- Median 90 months (range 44-126)
Methodological details2 tertiary centres
- 2 tertiary centres
Main finding
As reported in the abstract
Predictors of recurrence
- Invasiveness: HR 1.6 (1.10-2.37), P .02
- Elevated mitotic count: HR 2.17 (1.21-3.89), P .01
- Grade 2b vs 1a: HR 2.32 (1.06-5.03), P .03
- Absence of gross total resection: HR 3.70 (1.72-8.00), P .01
- Aggressiveness associated with elevated Ki67, mitotic count and invasiveness
Observational data: associations, not effects.
Further findings
Tumour characteristics
- Invasive
- 53%
- ≥2 proliferative marker positivity
- 10%
Interlaboratory reproducibility
- Ki67 reporting, moderate correlation (Phi)
- 0.620
- p53 reporting, poor reproducibility (Phi)
- 0.146
Original publication
Predictors of pituitary tumour behaviour: an analysis from long-term follow-up in 2 tertiary centres. Eur J Endocrinol. Published 18 July 2023. doi:10.
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