ECE2015 Guided Posters Pituitary – Hypopituitarism (9 abstracts)
Long-term follow-up of 520 patients with non-functioning pituitary adenomas from two large tertiary referral centres: a UK-Republic of Ireland collaborative study
Michael O’Reilly 1 , Saket Gupta 2 , C A Thompson 2 , Harriet Pearce 1 , Gabriella Bugg 1 , Andrew Toogood 1 , Neil Gittoes 1 , Christopher Thompson 2 & John Ayuk 1
1University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK; 2Beaumont Hospital, Dublin, Ireland.
Abstract
Non-functioning pituitary adenomas (NFPAs) are the most common pituitary tumours, often presenting with chiasmal compression or hypopituitarism. Surgical resection, accompanied by radiotherapy (RTX) in selected cases, is the treatment of choice for compressive tumours. Long-term health consequences of NFPAs and their treatment are unclear. In this retrospective study, we aimed to assess long-term pituitary function, recurrence and mortality in a large NFPA cohort across two tertiary centres.
Case-note review of all patients treated for NFPA in Queen Elizabeth Hospital Birmingham and Beaumont Hospital Dublin between 1997 and 2012 was performed; data on patients treated before 1997 was included where available. Clinical presentation, imaging characteristics, long-term pituitary function and co-morbidities were recorded in each case. Data on mortality was recorded via Clinical Portal in Birmingham and from GP contact in Dublin.
519 patients were included in the analysis (Birmingham n=271; Beaumont n=248; 59.2% male, mean age at presentation 55.2±14.1 years). Mean duration of follow-up was 8.5±6.3 years (0.5–43). 90.8% of patients underwent surgery (81.1% transsphenoidal). 184 patients (35.4%) underwent pituitary radiotherapy, either postoperatively (43.5%) or at recurrence (56.5%). Tumour regrowth was recorded in 35.6% of cases; mean time to regrowth was 47.6±51.6 months, (range 1–276). The incidence of panhypopituitarism was higher in irradiated patients (49.4% vs 38.1%, P<0.001). The incidence of second intracranial tumours was 3.2% and 0.6% in irradiated and non-irradiated patients respectively, P<0.001. 75 patients (14.5%) died during follow-up. Mean age at death in RTX and RTX-naïve patients was 69.8±12.7 vs 77.7±9.8 years, respectively, P=0.006.
This large collaborative study between Britain and Ireland highlights important health consequences in patients treated for NFPA. Tumour recurrence may occur many years after initial treatment, necessitating lifelong follow-up. Pituitary irradiation may have consequences on the risk of secondary intracranial tumours and on mortality. Further analysis is required to understand the associations observed here.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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