Related Experiment Video
Updated: Sep 12, 2025
07:43
Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
19.0K
Predictors of progression after surgery in non-functioning pituitary macroadenomas: a Spanish multicenter study
Betina Biagetti1,2, Andres Cardona-Arias3, Edelmiro Menéndez Torre4
1Endocrinology & Nutrition Department, Hospital Universitario Vall de Hebrón, Universitat Autònoma de Barcelona, CIBERER U747 (ISCIII), EndoERN, Barcelona, Spain. betinaloys.biagetti@vallhebron.cat.
Journal of Endocrinological Investigation
|August 8, 2025
Summary
Non-functioning pituitary adenomas (NFPAs) can progress, especially within 15 years. Residual tumor after surgery and aggressive pathology are key predictors of non-functioning pituitary adenoma progression, guiding long-term patient surveillance.
Area of Science:
- Endocrinology
- Neurosurgery
- Oncology
Background:
- Non-functioning pituitary adenomas (NFPAs) present unpredictable clinical courses.
- Tumor recurrence and progression are significant challenges in managing NFPAs.
Purpose of the Study:
- To evaluate progression-free survival (PFS) in patients with NFPAs.
- To identify predictors and patterns of tumor progression in NFPAs.
Main Methods:
- Retrospective multicenter study of 472 patients with NFPAs >1 cm.
- Tumor progression defined by size increase, imaging growth, or new/worsening symptoms.
- Kaplan-Meier analysis for PFS and Cox regression for progression predictors in the surgical cohort.
Main Results:
- 14.2% of patients experienced tumor progression over a median of 7.9 years.
- Most progression events (89.6%) occurred within 15 years.
- Residual tumor (HR=5.1) and aggressive histopathology (HR=2.1) were significant predictors of progression.
Conclusions:
- NFPAs exhibit a gradual progression risk, peaking within the first 15 years.
- Postoperative residual tumor and aggressive histopathology are the strongest progression predictors.
- Maximal safe resection and detailed histopathological assessment are crucial for risk stratification and long-term surveillance.
