دورية أكاديمية
Correlation of older age with better progression-free survival despite less aggressive resection in nonfunctioning pituitary adenomas.
| العنوان: | Correlation of older age with better progression-free survival despite less aggressive resection in nonfunctioning pituitary adenomas. |
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| المؤلفون: | Shinya Y; Departments of1Neurologic Surgery and.; 2Department of Neurosurgery, The University of Tokyo Hospital, Tokyo, Japan; and., Atkinson JLD; Departments of1Neurologic Surgery and., Erickson D; 3Division of Endocrinology, Diabetes, and Nutrition, Mayo Clinic, Rochester, Minnesota., Bancos I; 3Division of Endocrinology, Diabetes, and Nutrition, Mayo Clinic, Rochester, Minnesota., Pinheiro Neto CD; 4Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota., Davidge-Pitts CJ; 3Division of Endocrinology, Diabetes, and Nutrition, Mayo Clinic, Rochester, Minnesota., Peris Celda M; Departments of1Neurologic Surgery and., Herndon JS; 3Division of Endocrinology, Diabetes, and Nutrition, Mayo Clinic, Rochester, Minnesota., Hong S; Departments of1Neurologic Surgery and.; 2Department of Neurosurgery, The University of Tokyo Hospital, Tokyo, Japan; and., Van Gompel JJ; Departments of1Neurologic Surgery and. |
| المصدر: | Journal of neurosurgery [J Neurosurg] 2024 Apr 26; Vol. 141 (3), pp. 781-789. Date of Electronic Publication: 2024 Apr 26 (Print Publication: 2024). |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: American Association of Neurological Surgeons Country of Publication: United States NLM ID: 0253357 Publication Model: Electronic-Print Cited Medium: Internet ISSN: 1933-0693 (Electronic) Linking ISSN: 00223085 NLM ISO Abbreviation: J Neurosurg Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: Charlottesville, VA : American Association of Neurological Surgeons Original Publication: Chicago [etc.] |
| مواضيع طبية MeSH: | Pituitary Neoplasms*/surgery , Pituitary Neoplasms*/mortality , Pituitary Neoplasms*/pathology , Progression-Free Survival* , Adenoma*/surgery , Adenoma*/pathology , Adenoma*/mortality, Humans ; Male ; Middle Aged ; Female ; Aged ; Retrospective Studies ; Age Factors ; Adult ; Treatment Outcome ; Follow-Up Studies ; Aged, 80 and over ; Neurosurgical Procedures/methods ; Kaplan-Meier Estimate |
| مستخلص: | Objective: Nonfunctioning pituitary adenomas (NFPAs) present at a wide range of ages; it is possible that variable outcomes are based on patient age at presentation. This study aimed to explore long-term outcomes of patients with NFPAs following endonasal transsphenoidal surgery (ETS), considering age stratification. Methods: This retrospective study included 228 patients with NFPAs who underwent ETS, with a median follow-up period of 63 months. The outcomes included progression-free survival (PFS) rates and neurological and endocrinological outcomes. Age-stratified Kaplan-Meier and Cox proportional hazards analyses were performed. Patients were classified into four age groups: ≤ 49, 50-59, 60-69, and ≥ 70 years. Results: Age-stratified analysis showed a significant correlation between age and PFS in NFPAs (5-year PFS rates: 63.0% in those ≤ 49 years, 76.7% in those 50-59 years, 85.0% in those 60-69 years, and 88.1% in those ≥ 70 years; p = 0.001, log-rank test). Bivariate (HR 1.03, 95% CI 1.01-1.05; p = 0.001) and multivariable (HR 1.03, 95% CI 1.02-1.05; p = 0.001) analyses demonstrated that older age was significantly associated with longer PFS. Multivariable analysis also demonstrated that smaller maximum tumor diameter (HR 0.77, 95% CI 0.60-0.99; p = 0.036) and gross-total resection (HR 8.55, 95% CI 3.90-18.75; p = 0.001) were significantly associated with longer PFS. Multivariable logistic regression analysis demonstrated that only younger age was associated with postoperative improvement of male hypogonadism (HR 0.91, 95% CI 0.84-0.99; p = 0.019). Other postoperative neurological and endocrinological outcomes were not significantly associated with age. Conclusions: Older patients with NFPAs treated with ETS demonstrated a longer PFS. Of endocrinological outcomes studied, only male hypogonadism improvement was associated with younger patient age. |
| فهرسة مساهمة: | Keywords: age-dependent outcome; endonasal transsphenoidal surgery; nonfunctioning pituitary adenomas; pituitary surgery |
| تواريخ الأحداث: | Date Created: 20240426 Date Completed: 20240902 Latest Revision: 20240902 |
| رمز التحديث: | 20240902 |
| DOI: | 10.3171/2024.1.JNS232495 |
| PMID: | 38669710 |
| قاعدة البيانات: | MEDLINE |
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