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Published on: January 17, 2018
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Prospective Observational Study of 118 Clinically Nonfunctioning Pituitary Adenomas
Pamela U Freda1, Jeffrey N Bruce2, Kalmon D Post3
1Department of Medicine, Vagelos College of Physicians & Surgeons, Columbia University, New York, New York.
Summary
Observation of clinically nonfunctioning pituitary adenomas (CNFPAs) shows significant growth and surgery rates, even years after diagnosis. Male sex and macroadenomas predict increased risks, informing personalized follow-up strategies for these pituitary tumors.
Area of Science:
- Endocrinology
- Neurosurgery
- Oncology
Background:
- Clinically nonfunctioning pituitary adenomas (CNFPAs) are diagnosed based on imaging and lack of hormonal dysfunction.
- Understanding the natural history of CNFPAs managed conservatively is crucial for patient care.
Purpose of the Study:
- To evaluate the outcomes of observation alone for CNFPAs not requiring immediate surgery.
- To identify predictors of tumor growth and need for surgery in CNFPA patients.
Main Methods:
- Prospective observational study of 118 patients with apparent CNFPAs (≥ 6mm).
- Follow-up included clinical, endocrine, and imaging assessments according to European Society guidelines.
- Multivariable analysis was used to identify predictors of tumor growth and surgery.
Main Results:
- 49% of CNFPAs increased in size, with higher rates in macroadenomas (56%) versus microadenomas (31%).
- 24.6% of patients underwent surgery, with macroadenomas at diagnosis being a significant predictor.
- Male sex was a predictor of tumor growth.
Conclusions:
- CNFPA growth and the need for surgery can occur unpredictably, sometimes years after initial observation.
- Specific patient groups, including males and those with macroadenomas, face increased risks.
- These findings necessitate individualized follow-up plans for CNFPA management.
