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Women, young adults with nonfunctioning pituitary adenoma at higher risk for premature death
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Women and young adults with nonfunctioning pituitary adenoma have a higher risk for premature death, particularly women with hypopituitarism or diabetes insipidus, according to research in The Journal of Clinical Endocrinology & Metabolism.
In a population-based study of adults with nonfunctioning pituitary adenoma (NFPA) in Sweden, researchers also found that radiotherapy and multiple surgical procedures increased the risk for death in women and men, stressing the importance of both tumor size and aggressiveness.
“Although NFPA is a benign tumor, this study shows that the disease has a significant impact on mortality,” the researchers wrote. “Excess mortality was particularly seen in women and in patients [younger than] 40 years of age. In contrast, men with NFPA had the expected mortality ratio.”
Daniel S. Olsson, MD, PhD, of University of Gothenburg and Sahlgrenska University Hospital in Gothenburg, Sweden, and colleagues analyzed data from 2,795 patients diagnosed with NFPA between Janunary 1997 and December 2011 (1,502 men; mean age at diagnosis, 58 years) identified through the Swedish National Patient Registry. Researchers obtained information regarding radiotherapy and surgical treatments through the registry; the degree of hypopituitarism was not available.
Researchers found an increased mortality ratio in women with NFPA (1.29; 95% CI, 1.11-1.48) vs. men (1; 95% CI, 0.88-1.12). Women with hypopituitarism or diabetes insipidus also showed an increased risk for death — in particular with mortality due to circulatory diseases —whereas men and women without hormonal deficiencies did not.
In addition, patients diagnosed at or before the age of 40 years had a standardized mortality ratio of 2.68 (95% CI, 1.23-5.09). Patients who received radiotherapy, more than one surgical treatment or a combination of radiotherapy and one surgical procedure also had an increased risk for early death, according to researchers.
“This study stresses the need of targeted improvement in the management of women and young patients diagnosed with NFPA,” the researchers wrote. – by Regina Schaffer
Disclosure: Olsson reports receiving lecture fees from Pfizer and has been a consultant for Ipsen. Please see the full study for other authors’ relevant financial disclosures.
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