Mortality in patients with non-functioning pituitary adenoma is increased: systematic analysis of 546 cases with long follow-up

Georgia Ntali, Cristina Capatina, Violet Fazal-Sanderson, James V Byrne, Simon Cudlip, Ashley B Grossman, John A H Wass, Niki Karavitaki

Research output: Contribution to journalArticlepeer-review

28 Citations (Scopus)

Abstract

Objective: Non-functioning pituitary adenomas (NFAs) have a prevalence of 7–22/100 000 people. A significant number of patients suffer from morbidities related to the tumor, possible recurrence(s), and treatments utilized. Our aim was to assess mortality of patients with macroNFA and predictive factors. Design: Retrospective cohort study in a tertiary referral center in the UK. Methods: A total of 546 patients operated for a macroNFA between 1963 and 2011 were studied. Mortality data were retrieved through the National Health Service Central Register and hospital records and recorded as standardized mortality ratio (SMR). Mortality was estimated for the total and various subgroups with clinical follow-up data. Results: Median follow-up was 8 years (range: 1 month–48.5 years). SMR was 3.6 (95% CI, 2.9–4.5), for those operated before 1990, 4.7 (95% CI, 2.7–7.6) and for those after 1990, 3.5 (95% CI, 2.8–4.4). Main causes of death were cardio/cerebrovascular (33.7%), infections (30.1%), and malignancy (28.9%). Cox regression analysis demonstrated that only age at diagnosis remained an independent predictor of mortality (hazard ratio 1.10; 95% CI, 1.07–1.13, P<0.001), whereas sex, presentation with acute apoplexy, extent of tumor removal, radiotherapy, recurrence, untreated GH deficiency, FSH/LH deficiency, ACTH deficiency, TSH deficiency, and treatment with desmopressin had no impact. Conclusions: Despite the improvement of treatments over the last three decades, the mortality of patients with NFAs in our series remains high. Apart from age, factors related with the management/outcome of the tumor are not independent predictors, and pituitary hormone deficits managed with the currently-used substitution protocols do not adversely affect mortality.
Original languageEnglish
Pages (from-to)137-145
JournalEuropean Journal of Endocrinology
Volume174
Early online date6 Nov 2015
DOIs
Publication statusPublished - 1 Feb 2016

Fingerprint

Dive into the research topics of 'Mortality in patients with non-functioning pituitary adenoma is increased: systematic analysis of 546 cases with long follow-up'. Together they form a unique fingerprint.

Cite this