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— Jim Rohn

PNA Medical Corner: Age and progression-free survival with nonfunctioning pituitary adenomas

Dr. John Atkinson

Dr. Jamie Van Gompel

Dr. Maria Peris Celda

This month the PNA Medical Corner focuses on a study coauthored by three members of the PNA: Drs. John Atkinson, Jamie Van Gompel and Maria Peris Celda. They conclude that older patients with nonfunctioning pituitary tumors had better progression-free survival rates, even when they underwent aggressive surgery.

https://pubmed.ncbi.nlm.nih.gov/38669710/

Correlation of older age with better progression-free survival despite less aggressive resection in nonfunctioning pituitary adenomas

Yuki Shinya 1 2John L D Atkinson 1Dana Erickson 3Irina Bancos 3Carlos D Pinheiro Neto 4Caroline J Davidge-Pitts 3Maria Peris Celda 1Justine S Herndon 3Sukwoo Hong 1 2Jamie J Van Gompel 1

Abstract

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.

Keywords: age-dependent outcome; endonasal transsphenoidal surgery; nonfunctioning pituitary adenomas; pituitary surgery

Featured News and Updates

News Articles May 2024

Does a form of dwarfism improve cardiovascular risk?

A study in the Journal Med looks at the longevity of people with Laron’s Syndrome, who have low-growth hormone signaling that causes a form of dwarfism but may also confer lower risk of cancer and heart disease. Read more in the Daily Mail: https://tinyurl.com/5cdmafaj or consult the original study: https://tinyurl.com/2pvzzbev

Case study: Surgical Treatment of Pituitary Macroadenoma​s

A study published on Cureus.com looks at the case of a 48-year old woman with a pituitary macroadenoma. Surgeons removed the tumor but she suffered post-operative complications that required extensive management. They conclude that this type of surgery is complex and requires individualized care.

Acromegalic receives special-made shoes​

An article on Fox5dc.com features the story of an acromegaly patient in Venezuela who holds the record for the world’s biggest feet, according to the Guinness Book of World records. The man, named Jeison Rodriguez Hernandez, has size 26 feet and gets his shoes special-made a company in Germany. Read more: https://www.fox5dc.com/news/man-with-worlds-largest-feet-receives-new-custom-shoes

Study: Female Cushing’s patients develop more new diseases than men after treatment

An article in Cushing’s Disease news looks at a study published in the journal Endocrinology, Diabetes & Metabolism. Researchers found that women were more likely to develop additional diseases than men, when in remission after treatment for Cushing’s syndrome. Read more: https://cushingsdiseasenews.com/news/more-new-disorders-women-than-men-after-cushings-remission-study/

Research Articles

May 2024 Research Articles

Pituitary Surgery

The effect of preoperative TSH levels on perioperative complications in patients undergoing pituitary surgery.

Report on Pseudoaneurysm Caused by Injury of Internal Carotid Artery During Endoscopic Pituitary Surgery and Rebleeding After Treatment With Willis Covered Stent.

Efficacy of the Craniopharyngioma Resection via Expanded Endoscopic Endonasal Transsphenoidal Approach in the Treatment of Complex Craniopharyngioma and Its Effect on Pituitary Function and Complications of Patients.

Vascular complications in craniopharyngioma-resected paediatric patients: a single-center experience.

Cushing’s

Improvement in clinical features of hypercortisolism during osilodrostat treatment: findings from the Phase III LINC 3 trial in Cushing’s disease. 

Hormonal Health

Hypogonadotropic Hypogonadism. 

Long term pituitary function, functional- and patient reported outcomes in severe acquired brain injury. 
 

Panax ginseng Ameliorates Pituitary-Ovarian Dysfunction Induced by Radiofrequency Electromagnetic Radiation from Cell Phones via Upregulation of the CREM Signaling Pathway. 

Diagnosis and treatment of hypogonadism in men seeking to preserve fertility – what are the options? 

Pituitary Tumors

Rathke’s Cleft Cyst and Craniopharyngioma: A Continuum of the Same Spectrum? Insights from an Interesting Case and Previous Literature. 

Targeted therapy in BRAF mutated aggressive papillary craniopharyngioma: a case report and overview of the literature. 

Disulfiram mediated anti-tumour effect in pituitary neuroendocrine tumours by inducing cuproptosis. 

A long-term prognosis study of human USP8-mutated ACTH-secreting pituitary neuroendocrine tumours. 

Immune landscape and progress in immunotherapy for pituitary neuroendocrine tumors.

 

The FDA has approved NGENLA (somatrogon-ghla)

The FDA has approved NGENLA (somatrogon-ghla), a once-weekly, human growth hormone analog indicated for treatment of pediatric patients aged three years and older who have growth failure due to an inadequate secretion of endogenous growth hormone.

See the Press Release here>

Count on your Xeris CareConnection™ Team for unparalleled Cushing’s Support

Cushing’s can be challenging, but there is support so patients can feel like themselves again. The main goal of treating Cushing’s is to get cortisol levels back to normal. This Pituitary Awareness Month, Xeris Pharmaceuticals® is highlighting the importance of one-on-one support for patients living with Cushing’s Syndrome and support for HCPs treating Cushing’s Syndrome.

Sign up to get dedicated support:

Patients: Sign up for support | Recorlev® (levoketoconazole)

HCP’s: Connect with Xeris support | RECORLEV® (levoketoconazole)

Have more questions? Call for more support at 1-844-444-RCLV (7258)

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