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Differences in invasiveness and recurrence rate among nonfunctioning pituitary neuroendocrine tumors depending on tumor subtype

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Abstract

Purpose

To clarify the invasiveness to surrounding structures and recurrence rate of each subtype of nonfunctioning pituitary neuroendocrine tumor (Pit-NETs) according to the WHO 2022 classification.

Methods

This retrospective study utilized data from 292 patients with nonfunctioning Pit-NETs treated with initial transsphenoidal surgery. Recurrence was evaluated on 113 patients who were available for a magnetic resonance imaging follow-up ≥ 60 months. All tumors were assessed by immunohistochemical staining for Pit-1, T-PIT, and GATA3. Invasiveness to surrounding structures was evaluated based on intraoperative findings.

Results

Cavernous sinus invasion was found in 47.5% of null cell tumors, 50.0% of Pit-1 lineage tumors, 31.8% of corticotroph tumors, and 18.3% of gonadotroph tumors. Dura mater defects in the floor of sellar turcica, indicating dural invasion, were found in 44.3% of null cell tumors, 36.4% of corticotroph tumors, 16.7% of Pit-1 lineage tumors, and 17.3% of gonadotroph tumors. In logistic regression analysis, Pit-1 (OR 5.90, 95% CI 1.71–20.4, P = 0.0050) and null tumors (OR 4.14, 95% CI 1.86–9.23, P = 0.0005) were associated with cavernous sinus invasion. Recurrence was found in 8 (4.9%) patients, but without significant differences between tumor subtypes. The presence of cavernous sinus invasion was correlated with recurrence (HR = 1.95, 95% CI 1.10–3.46, P = 0.0227).

Conclusion

Among nonfunctioning Pit-NETs, Pit-1 lineage tumors tend to invade the cavernous sinus, corticotroph tumors may produce dura mater defects, and null cell tumors tend to cause both. Pit-NETs with cavernous sinus invasion require a careful attention to recurrence.

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Acknowledgements

We gratefully acknowledge the work of past and present members of Hiroshima University Hospital. The authors would like to thank Enago (www.enago.jp) for the English language review.

Funding

This work was supported by JSPS Grant-in-Aid for Scientific Research (C) (Grant number [JP23K06697]).

Author information

Authors and Affiliations

  1. Department of Neurosurgery, Graduate School of Biomedical and Health Science, Hiroshima University, Hiroshima, Japan

    Akira Taguchi, Yasuyuki Kinoshita, Shumpei Onishi, Fumiyuki Yamasaki & Nobutaka Horie

  2. Department of Pathology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan

    Vishwa Jeet Amatya & Yukio Takeshima

  3. Medical Division Technical Center, Hiroshima University, Hiroshima, Japan

    Yukari Go

  4. Department of Neurosurgery and Neuro-Endovascular Therapy, Hiroshima Prefectural Hospital, Hiroshima, Japan

    Atsushi Tominaga

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  1. Akira Taguchi
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Contributions

Conception and design: Akira Taguchi. Acquisition of data: Akira Taguchi, Yasuyuki Kinoshita, Shumpei Onishi, Atsushi Tominaga. Analysis and interpretation: Akira Taguchi, Fumiyuki Yamasaki, Yasuyuki Kinoshita, Vishwa Jeet Amatya, Shumpei Onishi, Yukari Go. Drafting the article: Akira Taguchi. Critically revising the article: Fumiyuki Yamasaki, Yasuyuki Kinoshita, Yukio Takeshima, Nobutaka Horie. Reviewed submitted version of manuscript: all authors. Statistical analysis: Akira. Taguchi, Yasuyuki Kinoshita, Fumiyuki Yamasaki. Administrative/technical/material support: Vishwa Jeet Amatya, Atsushi Tominaga, Yukio Takeshima. Study supervision: Fumiyuki Yamasaki, Nobutaka Horie.

Corresponding author

Correspondence to Akira Taguchi.

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Ethics approval

This study was conducted retrospectively, utilized data obtained for clinical purposes, and was approved by the ethics committee of Hiroshima University Hospital (E-2022, May 18, 2020).

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As patient data in this study are completely anonymized, any identification of individuals is difficult. Pertinent research content is available in the homepage of our institution.

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Taguchi, A., Kinoshita, Y., Amatya, V.J. et al. Differences in invasiveness and recurrence rate among nonfunctioning pituitary neuroendocrine tumors depending on tumor subtype. Neurosurg Rev 46, 317 (2023). https://doi.org/10.1007/s10143-023-02234-7

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