Abstract
Purpose
Outcomes of patients with non-functioning pituitary adenomas categorized using the 2004 and 2017 WHO classification systems are understudied. We report outcomes from the University of Virginia of patients with non-functioning pituitary adenomas categorized using both systems.
Methods
We constructed a database from all 239 patients who underwent resection of a non-functioning pituitary adenoma between 2003 and 2015 and had at least 5 years of follow-up. Pathologic diagnosis was determined under both the 2004 and 2017 WHO classification systems. We compared the rates of recurrence and progression between subtypes using univariate and multivariate Cox regression analyses.
Results
Nearly 30% of the tumors in our database were classified as null cell adenomas under the 2004 classification system, whereas only 10% of the tumors were classified as null cell adenomas using the 2017 classification system. Most of these tumors were reclassified as either corticotroph or gonadotroph adenomas. Despite our relatively large cohort and average follow-up of nearly 9 years, we did not detect a significant difference in recurrence and progression between subtypes.
Conclusions
The majority of null cell adenomas diagnosed under the 2004 WHO classification system are reclassified as gonadotroph or corticotroph adenomas under the 2017 WHO classification system. Rates of progression and recurrence between subtypes are not as different as previously believed at our institution and require a larger cohort to further investigate.
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Support by the University of Virginia Department of Pathology Research Fund.
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MBSL, JJJ, DT, PP, AC, and ME designed the study. AC, JK, PP, JA, ME, LCY, AW, JDS, and DT collected data for the study. AC analyzed performed the statistical analyses for the study and created all figures and tables. AC and JK wrote the initial draft of the manuscript. MBSL, JJJ, DT, and JDS supervised the study. All authors reviewed the manuscript.
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This study was approved by the Institutional Review Board at the University of Virginia (IRB #20423).
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Chatrath, A., Kosyakovsky, J., Patel, P. et al. Impact of histopathological classification of non-functioning adenomas on long term outcomes: comparison of the 2004 and 2017 WHO classifications. Pituitary 25, 988–996 (2022). https://doi.org/10.1007/s11102-022-01281-5
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DOI: https://doi.org/10.1007/s11102-022-01281-5