ECE2017 Eposter Presentations: Pituitary and Neuroendocrinology Pituitary - Clinical (145 abstracts)
Residual tumour diameter may influence reduced survival in females with nonfunctioning pituitary macroadenomas
Simona Galoiu 1, , Iulia Burcea 1 , Simona Silea 1 , Oana Voicu 1 , Ionela Baciu 1, , Anda Dumitrascu 2 , Andra Caragheorgheopol 2 & Catalina Poiana 1,
1Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; 2C.I. Parhon National Institute of Endocrinology, Bucharest, Romania.
Objective: Patients with pituitary macroadenomas and concomitant hypopituitarism have a reduced life expectancy due to various comorbidities.
Aim: To investigate mortality in patients with non-functioning pituitary adenomas (NFAs) and independent prognostic factors influencing survival.
Design: Retrospective cohort study in a tertiary neuroendocrine university department.
Methods: A total of 364 patients (177F/187M) evaluated for a macroNFA between 2001 and 2016 were studied. PAMCOMP computation program was used to calculate standardized mortality ratio (SMR). Cox regression analysis revealed independent factors associated with mortality.
Results: During follow-up (median 7.5 years – 2135.94 person years), 47 patients died, versus 33 expected from general population, corresponding to a SMR of 1.39 (95% CI 1.02–1.84). Females had a doubled mortality ratio: SMR 2.13 (95%CI 1.30–3.29. 254 patients (69.8%) were operated and 87 patients (23.9%) were irradiated. After pituitary surgery and/or radiotherapy, pituitary tumour remnant diameter decreased with 35.62±37.35% (range 0–100%). Only 24 (6.6%) of patients were cured after radical therapy (no remnant). Cox-regression analysis demonstrated that age at diagnosis and pituitary tumour diameter at last evaluation remained independent predictor factors correlated to mortality (hazard ratio HR 1.07 (95%CI 1.046–1.101, P<0.001 and respectively HR 1.02 (95% CI 1.046–1.101, P=0.018)), whereas pituitary surgery or radiotherapy, pituitary failure had no impact.
Conclusions: In our patients with pituitary NFA mortality is still increased, especially in women, influenced independently by the age at diagnosis and residual pituitary tumour diameter. A greater extent of tumour removal may increase survival.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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