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Journal of Neuro-Oncology

, Volume 146, Issue 2, pp 219–227 | Cite as

Current status and treatment modalities in metastases to the pituitary: a systematic review

  • Sam NgEmail author
  • Franklin Fomekong
  • Violaine Delabar
  • Timothée Jacquesson
  • Ciprian Enachescu
  • Gerald Raverot
  • Romain Manet
  • Emmanuel Jouanneau
Topic Review

Abstract

Background

Metastases to the pituitary (MP) are uncommon, accounting for 0.4% of intracranial metastases. Through advances in neuroimaging and oncological therapies, patients with metastatic cancers are living longer and MP may be more frequent. This review aimed to investigate clinical and oncological features, treatment modalities and their effect on survival.

Methods

A systematic review was performed according to PRISMA recommendations. All cases of MP were included, excepted primary pituitary neoplasms and autopsy reports. Descriptive and survival analyses were then conducted.

Results

The search identified 2143 records, of which 157 were included. A total of 657 cases of MP were reported, including 334 females (50.8%). The mean ± standard deviation age was 59.1 ± 11.9 years. Lung cancer was the most frequent primary site (31.0%), followed by breast (26.2%) and kidney cancers (8.1%). Median survival from MP diagnosis was 14 months. Overall survival was significantly different between lung, breast and kidney cancers (P < .0001). Survival was impacted by radiotherapy (hazard ratio (HR) 0.49; 95% confidence interval (CI) 0.35–0.67; P < .0001) and chemotherapy (HR 0.58; 95% CI 0.36–0.92; P = .013) but not by surgery. Stereotactic radiotherapy tended to improve survival over conventional radiotherapy (HR 0.66; 95% CI 0.39–1.12; P = .065). Patients from recent studies (≥ 2010) had longer survival than others (HR 1.36; 95% CI 1.05–1.76; P = .0019).

Conclusion

This systematic review based on 657 cases helped to better identify clinical features, oncological characteristics and the effect of current therapies in patients with MP. Survival patterns were conditioned upon primary cancer histologies, the use of local radiotherapy and systemic chemotherapy, but not by surgery.

Keywords

Pituitary Metastasis Sella Radiotherapy Surgery 

Notes

Funding

None.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no relevant financial relationships or conflict of interest to disclose.

Informed consent

This research did not involve humans, and no informed consent was required.

Supplementary material

11060_2020_3396_MOESM1_ESM.docx (15 kb)
Supplementary file 1 (DOCX 14 kb)
11060_2020_3396_MOESM2_ESM.docx (33 kb)
Supplementary file 2 (DOCX 33 kb)
11060_2020_3396_MOESM3_ESM.tiff (254 kb)
Supplementary Material 3: Survival analysis based on surgical technique: Biopsy versus Debulking versus Gross Total resection. N=99. (TIFF 253 kb)
11060_2020_3396_MOESM4_ESM.tiff (718 kb)
Supplementary Material 4: Survival analysis based on radiotherapy technique: conventional multifractional radiotherapy versus stereotactic radiotherapy. N=103. (TIFF 718 kb)
11060_2020_3396_MOESM5_ESM.tiff (675 kb)
Supplementary Material 5: Survival analysis based on radiotherapy technique: conventional multifractional radiotherapy versus stereotactic radiotherapy after 2010. N=36. (TIFF 674 kb)

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2020

Authors and Affiliations

  1. 1.Department of Neurosurgery, Gui de Chauliac HospitalMontpellier University Medical CenterMontpellier Cedex 5France
  2. 2.Department of Skull Base and Pituitary Surgery, Neurological Hospital Pierre WertheimerHospices Civils de LyonLyonFrance
  3. 3.CREATIS Laboratory CNRS UMR5220, Inserm U1206, INSA-LyonUniversity of LyonLyonFrance
  4. 4.Claude Bernard Lyon 1 UniversityUniversity of LyonLyonFrance
  5. 5.Department of Radiotherapy, Lyon Sud HospitalHospices Civils de LyonLyonFrance
  6. 6.Endocrinology Department, Reference Center for Rare Pituitary Diseases, Groupement Hospitalier EstHospices Civils de LyonLyonFrance
  7. 7.CNRS UMR5286, Inserm U1052Cancer research Center of LyonLyonFrance

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