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Non-Functioning Pituitary Macroadenoma: Surgical Outcomes, Tumor Regrowth, and Alterations in Pituitary Function—3-Year Experience From the Iranian Pituitary Tumor Registry Publisher Pubmed



Najmaldin A1 ; Malek M2 ; Madani NH1 ; Ghorbani M3 ; Akbari H4 ; Khajavi A5 ; Qadikolaei OA1 ; Khamseh ME1
Authors
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Authors Affiliations
  1. 1. Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences (IUMS), No. 10, Firoozeh St., Vali-asr Ave., Vali-asr Sq, Tehran, Iran
  2. 2. Research Center for Prevention of Cardiovascular Disease, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran
  3. 3. Division of Vascular and Endovascular Neurosurgery, Firoozgar Hospital, Iran University of Medical Sciences (IUMS), Tehran, Iran
  4. 4. Golestan University of Medical Sciences, Gorgan, Iran
  5. 5. Student Research Committee, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Source: Hormones Published:2019


Abstract

Purpose: The aim of this study was to assess clinical features and therapeutic outcomes in patients with clinically non-functioning pituitary macroadenomas (NFPMAs). Method: This is a retrospective cohort study of NFPMA patients treated surgically and followed periodically between 2015 and 2017 in a tertiary care center in Iran. Descriptive analysis was performed applying appropriate tests. Binary logistic regression models were used to determine the predictive factors for subtotal tumor resection (STR) and hormonal recovery. Data were analyzed by Stata software. Result: A total of 71 patients with a mean age of 50.6 ± 1.4 years were studied. The mean diameter of the adenoma was 26.8 ± 1.1 mm. The most frequent symptoms were headache (85.75%), visual field defect (VFD) (78.3%), and hypogonadal symptoms (40.3%). Gross total resection (GTR) was achieved in 45.1%. Preoperative hypopituitarism was observed in 50.7% of patients. Recovery of at least one axis occurred in 36.1% of the patients suffering from hypopituitarism preoperatively, while new-onset postoperative hormonal deficiency appeared in 14.3% of patients. Multivariate analyses showing preoperative tumor size (OR = 38.2; P = 0.008) and cavernous sinus extension (OR = 13.4; P = 0.020) were predictors of STR. Moreover, hormonal recovery was observed not to be related to age, gender, tumor size, or the extent of tumor resection. Conclusions: Tumor size and cavernous sinus extension are the main predictors for STR. Notably, recovery of the gonadal axis in a large proportion of patients supports the surgical resection of NFPAM in patients suffering from gonadal deficiency, even in the absence of VFD. © 2019, Hellenic Endocrine Society.
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3. Cell Proliferation, Apoptosis, and Angiogenesis in Non-Functional Pituitary Adenoma: Association With Tumor Invasiveness, Endocrine (2020)
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