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Early postoperative growth in non-functioning pituitary adenomas: A tool to tailor safe follow-up
Natl Hosp Norway, Sect Specialized Endocrinol, Dept Endocrinol, Oslo Univ Hosp, Pb 4950 Nydalen, N-0424 Oslo, Norway.;Univ Oslo, Fac Med, Oslo, Norway..
Univ Oslo, Inst Basic Med Sci, Dept Biostat, Oslo Ctr Biostat & Epidemiol, Oslo, Norway..
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Immunology, Genetics and Pathology, Clinical and experimental pathology. Oslo Univ Hosp, Dept Pathol, Sognsvannsveien 20, N-0372 Oslo, Norway..ORCID iD: 0000-0001-7376-7331
Univ Oslo, Fac Med, Oslo, Norway.;Natl Hosp Norway, Dept Radiol & Nucl Med, Oslo Univ Hosp, Oslo, Norway..
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2017 (English)In: Endocrine (Basingstoke), ISSN 1355-008X, E-ISSN 1559-0100, Vol. 57, no 1, p. 35-45Article in journal (Refereed) Published
Abstract [en]

Non-functioning pituitary adenomas are common, and the treatment and follow-up of these patients represent a multidisciplinary challenge. First line treatment is transphenoidal surgery, with debulking or total removal of tumour. A substantial portion of the tumours relapse after surgery, and there is no consensus of how to follow these patients postoperatively. Our aim was to characterize the postoperative growth of non-functioning pituitary adenomas and correlate it to clinical and paraclinical data.

We retrospectively registered 52 patients operated for non-functioning pituitary adenomas, with four or more consecutive MR-investigations not interrupted by secondary treatment. Adenoma volumes were estimated by the Cavalieri principle with summation of manually drawn areas multiplied by slice interval. Growth curves were modelled and tumour volume doubling time was calculated for 39 tumours with regrowth after surgery.

A total of 13 tumours showed exponential growth, 10 linear growth and 16 logistic growth after surgery. The remaining 13 did not show regrowth of tumour. Seven of the exponential growing tumours underwent secondary surgery, compared to one and two of linear and logistic growing tumours (p = 0.03), respectively. Initial tumour volume doubling time was significantly lower in logistic growing tumours than in exponential growing tumours (p < 0.01). Men had tumours with lower tumour volume doubling time than women (p = 0.03). None of the tumours demonstrated signs of accelerated growth.

Residual tumours following surgery frequently grow. The logistic growing tumours had the fastest initial growth in our cohort. We found no indication of accelerated growth, whereby the tumour volume doubling time might be used to predict a "worst-case" scenario when planning follow-up of these patients.

Place, publisher, year, edition, pages
2017. Vol. 57, no 1, p. 35-45
Keywords [en]
Anterior pituitary, Tumour volume doubling time, Non-functioning pituitary adenoma, Growth dynamics, prognosis
National Category
Endocrinology and Diabetes
Identifiers
URN: urn:nbn:se:uu:diva-329707DOI: 10.1007/s12020-017-1314-5ISI: 000403670300006PubMedID: 28516382OAI: oai:DiVA.org:uu-329707DiVA, id: diva2:1147984
Available from: 2017-10-09 Created: 2017-10-09 Last updated: 2017-10-09Bibliographically approved

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