ECEESPE2025 Poster Presentations Pituitary, Neuroendocrinology and Puberty (162 abstracts)
Validation of the PANOMEN-3 predictive model for tumor recurrence and progression in pituitary tumors. a real-world spanish multicenter study
Marta Araujo Castro 1 , Edelmiro Luis Menendez Torre 2 , Laura Gonzalez Fernandez 3 , Ana Irigaray 4 , Maria Dolores Moure Rodriguez 5 , Miguel Paja 6 , Fernando Guerrero 7 , Cristina Novo-Rodríguez 8 , Rocio Villar Taibo 9 , María Calatayud 10 , Patricia Martin Rojas 11 , José María Recio 12 , Ana Aulinas 13 , Maria Dolores Aviles Perez 14 , Inmaculada Gonzalez-Molero 15 , Felicia A Hanzu 16 & Betina Biaggeti 17
1Hospital Universitario Ramón y Cajal, Endocrinology & Nutrition, Madrid, Spain; 2Hospital Universitario Central de Asturias, Instituto de Investigación Sanitaria del Principado de Asturias (ISPA)., Oviedo, Spain; 3Hospital Universitario Gregorio Marañón, Madrid, Spain; 4Hospital Universitario Navarra, Navarra, Spain; 5Hospital Universitario de Cruces, Bilbao, Spain; 6OSI Bilbao-Basurto. Hospital Universitario de Basurto., Bilbao, Spain; 7Hospital Universitario de Bellvitge, Cataluña, Spain; 8Hospital Universitario Virgen de las Nieves, Granada, Spain; 9Hospital Universitario de Santiago de Compostela., Santiago de Compostela, Spain; 10Hospital Universitario Doce de Octubre., Madrid, Spain; 11Hospital Universitario La Paz, Madrid, Spain; 12Hospital Universitario de Salamanca, Salamanca, Spain; 13Hospital de la Santa Creu i Sant Pau, IR-SANT PAU, CIBERER U747 (ISCIII), Barcelona, Spain; 14Hospital Universitario Clínico San Cecilio., Granada, Spain; 15Hospital Regional Universitario de Málaga, Málaga, Spain; 16Hospital Clinic de Barcelona, Barcelona, Spain; 17Hospital Universitario Vall de Hebrón., Barcelona, Spain
JOINT903
Background: the aim of our study was to validate the classification proposed by the PANOMEN-3 group for the prediction of tumor recurrence and or progression in pituitary tumors (PTs).
Methods: Multicenter national case-control study of patients with PTs followed for at least 5 years. Kaplan-Meier curves were used to assess the time to tumor recurrence/progression. Uni- and multivariate Cox regression analyses were used to estimate the hazard ratio [HR] and prognostic capacity of the classification proposed by the PANOMEN-3 group.
Findings: One thousand patients were included, 500 were males and 500 females. The mean age at diagnosis was 51.7±15.7 years. Pituitary surgery was performed in 809 patients and the remaining 191 patients were followed with active-surveillance or medical treatment. After a median follow-up of 8.3 (range 5-30) years, there were 244 (24.4%) patients who experienced tumor recurrence or biochemical/radiologic progression; and were thus classified as cases (231 in the surgical group and 13 in the conservative/medical treatment group). Of the 231 cases, 37 had tumor recurrence after surgical cure, 175 had significant tumor growth and 42 functioning PTs had experienced significant biochemical progression. The other 756 patients remained stable and thus, were classified as controls. The median recurrence-free survival was 16.5 years [95% CI: 14.9 to 18.7], indicating that 50% of patients experienced a recurrence within this period of time. At the last follow-up, 39 patients had died; 6 of 244 (2.5%) in the case group and 33 of 756 (4.4%) in the control group (P = 0.18). The diagnostic accuracy of the PANOMEN-3 model to predict recurrence/progression was 77.8% (95% CI 0.734-0.822). Residual tumor (HR 2.67, P < 0.001), hereditary syndrome (HR 12.62, P = 0.015) and active secretory status (HR 1.82, P = 0.028) were the most important variables in this model. There was a significantly positive tendency to increase the incidence of recurrence as the PANOMEN-3 grade increased (Mantel-Haenszel Test for linear Trend: Chi2 = 34.17, P < 0.001). The differences in survival were evident when comparing the four grades (PANOMEN 0, 1, 2 and 3), especially between grade 0 and 1 compared to 2 and 3 (0% in grade 0; 12% in grade 1, 32% in grade 2 and 35% in grade 3; P < 0.001).
Interpretation: The predictive model proposed by the PANOMEN-3 group may be useful to guide the prognosis and therapy of PTs in the Spanish population since it offers a good accuracy to predict tumoral/biochemical recurrence and/or progression in operated and non-operated patients.
Volume 110
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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