ECE2017 Eposter Presentations: Pituitary and Neuroendocrinology Pituitary - Clinical (145 abstracts)
Risk factors for progression of the surgical remnant of non-functioning pituitary adenomas in patients treated with dopamine agonists
Elena Fernández González , Miguel Sampedro Nuñez , Ana Ramos Leví , Ana Rabé Caón , Isabel Hughet , Nerea Aguirre Moreno , Clara Marijuán Sánchez , Begoña Pla Peris , Ángeles Maillo Nieto , Alicia Vicuña Andrés , Pedro Martínez Flores & Mónica Marazuela Azpiroz
Hospital Universitario La Princesa, Madrid, Spain.
Introduction: Surgery is the treatment of choice for non-functioning pituitary adenomas (NFPA), but remnants are frequently observed. Management of these remnants include observation (OBS), radiotherapy (RT) and/or dopamine agonist (DA) therapy. In this study, we evaluate the progression-free survival (PFS) of NFPA with postoperative remnant and the potential factors involved.
Methods: We performed a single-center ambispective study of a cohort of 72 patients (age 56±15 years, 32 women), with NFPA and tumor remnant after transsphenoidal (TS) surgery, followed-up between 1994 and 2015. We categorized patients as stable (n=36) or progression (n=21), according to radiological criteria. No follow-up data were available for 10 patients and 5 cases died. We evaluated differences between patients according to the three postoperative approaches: OBS, DA and/or RT. Statistical analysis was performed with STATA v12.0. We present data for progression-free time medians (p 25-75), correlation coefficient (r) and Hazard Ratio (HR).
Results: Progression-free survival (PFS) of the total cohort of patients was 154 months (77-184). Subgroup analysis suggested longer PFS in OBS patients (154m) vs. RT(184m) (P=0.07). Univariate analysis indicates an increased risk of progression in patients without RT (HR: 3.6; [0.8–15]; P=0.09). Duration of DA treatment was positively correlated with PFS (r=0.60; P<0.05), and each additional month showed a favorable trend for an increased PFS (HR: 0.98; [0.95–1.00]; P=0.06). Sex, age, and postoperative tumor diameter were not associated with PFS. Subanalysis of the subgroup of patients who received DA(n=20) showed that the only influencing factor for progression was female sex (χ2=5.05; P=0.02).
Conclusions: RT of operated NFPA seems to be associated to a higher PFS in our cohort. Prolonged treatment with DA also favored an increased PFS. Long-term follow-up and active management of patients with NFPA are important.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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