Endocrine

, Volume 57, Issue 1, pp 35–45 | Cite as

Early postoperative growth in non-functioning pituitary adenomas; A tool to tailor safe follow-up

  • Kristin Astrid Øystese
  • Manuela Zucknick
  • Olivera Casar-Borota
  • Geir Ringstad
  • Jens Bollerslev
Endocrine Methods and Techniques

Abstract

Purpose

Non-functioning pituitary adenomas are common, and the treatment and follow-up of these patients represent a multidisciplinary challenge. First line treatment is transphenoidal surgery, with debulking or total removal of tumour. A substantial portion of the tumours relapse after surgery, and there is no consensus of how to follow these patients postoperatively. Our aim was to characterize the postoperative growth of non-functioning pituitary adenomas and correlate it to clinical and paraclinical data.

Methods

We retrospectively registered 52 patients operated for non-functioning pituitary adenomas, with four or more consecutive MR-investigations not interrupted by secondary treatment. Adenoma volumes were estimated by the Cavalieri principle with summation of manually drawn areas multiplied by slice interval. Growth curves were modelled and tumour volume doubling time was calculated for 39 tumours with regrowth after surgery.

Results

A total of 13 tumours showed exponential growth, 10 linear growth and 16 logistic growth after surgery. The remaining 13 did not show regrowth of tumour. Seven of the exponential growing tumours underwent secondary surgery, compared to one and two of linear and logistic growing tumours (p = 0.03), respectively. Initial tumour volume doubling time was significantly lower in logistic growing tumours than in exponential growing tumours (p < 0.01). Men had tumours with lower tumour volume doubling time than women (p = 0.03). None of the tumours demonstrated signs of accelerated growth.

Conclusion

Residual tumours following surgery frequently grow. The logistic growing tumours had the fastest initial growth in our cohort. We found no indication of accelerated growth, whereby the tumour volume doubling time might be used to predict a “worst-case” scenario when planning follow-up of these patients.

Keywords

Anterior pituitary Tumour volume doubling time Non-functioning pituitary adenoma Growth dynamics prognosis 

Notes

Author contributions

K.A.Ø. and J.B. designed the research studies. K.A.Ø. and G.A.R. performed the volume registrations. O.C.B. performed the immunohistochemical investigations. M.Z. performed the growth model fitting. K.A.Ø. and M.Z. analyzed the data. K.A.Ø., M.Z., O.C.B., G.A.R. and J.B. wrote the manuscript.

Compliance with ethical standards

Conflict of interest

Jens Bollerslev is a member of the advisory board of JCEM and Endocrine. The remaining authors declare that they have no competing interests.

Ethical approval

The study was approved by the regional ethics committee and hospital authority

Informed consent

The informed consentwas obtained from all living patients.

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Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  1. 1.Section of Specialized Endocrinology, Department of EndocrinologyOslo University Hospital RikshospitaletOsloNorway
  2. 2.Faculty of MedicineUniversity of OsloOsloNorway
  3. 3.Oslo Centre for Biostatistics and Epidemiology, Department of Biostatistics, Institute of Basic Medical SciencesUniversity of OsloOsloNorway
  4. 4.Department of Immunology, Genetics and PathologyUppsala University, Rudbeck LaboratoryUppsalaSweden
  5. 5.Department of Clinical Pathology and CytologyUppsala University Hospital, Rudbeck LaboratoryUppsalaSweden
  6. 6.Department of PathologyOslo University HospitalOsloNorway
  7. 7.Department of Radiology and Nuclear MedicineOslo University Hospital- RikshospitaletOsloNorway
  8. 8.Section of Specialized Endocrinology, Department of EndocrinologyOslo University Hospital RikshospitaletOsloNorway

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