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Mortality remains high for patients with non-functioning pituitary macroadenoma

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Mortality remains high for patients with non-functioning pituitary macroadenoma, despite improvements over the last 30 years, according to recent study findings presented at the Society for Endocrinology Annual Conference.

Georgia Ntali , MD, PhD, of the Oxford Center for Diabetes and Churchill Hospital in Oxford, U.K., and colleagues analyzed data from 546 adults (333 men; mean age at surgery, 59 years) diagnosed with non-functioning pituitary macroadenoma (NFA) seen at a referral center in the United Kingdom between 1963 and 2011. Mortality data was available for all patients covering a median of 8 years; 83 patients died (mean age of death, 78 years). The leading cause of death was cardiovascular or cerebrovascular (34%), followed by infections (30.1%), malignancies (28.9%) or other causes.

The standardized mortality ratio for the cohort was 3.63 (95% CI, 2.9-4.47). For patients diagnosed before 1990, the SMR was 4.66 (95% CI, 2.65-7.63), while the SMR for patients diagnosed after 1990 was 3.53 (95% CI, 2.77-4.44).

Clinical follow-up data was available for 436 patients in the cohort (269 men; mean age at surgery, 59 years). Among patients with follow-up data, 111 experienced NFA regrowth; 188 received radiotherapy as initial treatment or for regrowth.

After univariate and multivariate Cox regression analysis, the researchers found that only age — not NFA regrowth, radiotherapy, sex, extent of tumor removal, untreated growth hormone deficiency, adrenocorticotropic hormone (ACTH) deficiency, thyroid-stimulating hormone deficiency or treatment with 1-deamino-8-D-arginine vasopressin (DDAVP) — remained an independent, significant factor, with an HR of 1.099 (95% CI, 1.073-1.126).

“Apart from age, factors related with the management/outcome of the tumor are not independent predictors,” the researchers wrote. “Pituitary hormone deficits managed with the currently used substitution protocols do not adversely affect mortality in this group of patients.” – by Regina Schaffer

Reference:

Ntali G, et al. P310. Presented at: Society for Endocrinology Annual Conference; Nov. 2-4, 2015; Edinburgh.

Disclosure: Endocrine Today was unable to confirm relevant financial disclosures.