IES2025 Oral Communications Oral Communications (14 abstracts)
The natural history of pituitary neuroendocrine tumours managed conservatively
L Cussen 1,2 , D Green 1 , E Griffin 1 , M Ahmed 1 , K Burke 1 , T Farrell 1 , M Javadpour *1,2 & A Agha *1,2
1Beaumont Hospital, Dublin, Ireland; 2Royal College of Surgeons, Dublin, Ireland *Prof Agha and Javadpour contributed to this equally
We previously reported a pilot study on the rate of progression of a small number of conservatively managed pituitary neuroendocrine tumours (pitNETs) with a short follow-up. This study presents a 10-year follow-up of a larger cohort and examines predictors of progression. We reviewed 87 adults with non-functioning pitNETs (≥10 mm ) monitored for at least 6 months between 2010 and 2020. Two blinded neuroradiologists independently assessed all MRIs, defining progression as a ≥20% increase in volume. Kaplan-Meier analysis and multivariable logistic regression models were used for analysis. Median follow-up was 63 months. Baseline visual field (VF) defects and hypopituitarism were present in 36% and 34% of patients, respectively. Thirty-two patients (37%) progressed: 22 radiologically, 10 by VF decline, and 8 by both. Cumulative growth probabilities were 1.2% , 7.1% , 19% and 31.6% at 6, 12, 24 and 60 months, respectively, plateauing thereafter. Baseline VF defects independently predicted progression (OR 5.6, 95% CI 1.5-20.4, p value 0.009) but not tumour size, hypopituitarism, age, gender or tumour extension. An independent neuroradiology review downgraded 35% of the initially reported progression, and none of these downgrades had adverse clinical consequences. Surgery was undertaken in 31% of the progressed cases, mainly due to visual compromise. This extended larger 10-year follow-up study delineates the rate of growth of these tumours which mainly occur in the first 2-5 years of follow-up and is strongly associated with baseline VF defects. These findings support intensified early surveillance and consideration of earlier surgical intervention in high-risk patients.
Volume 115
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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