“Take care of your body. It’s the only place you have to live in.”
— 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 2, John L D Atkinson 1, Dana Erickson 3, Irina Bancos 3, Carlos D Pinheiro Neto 4, Caroline J Davidge-Pitts 3, Maria Peris Celda 1, Justine S Herndon 3, Sukwoo Hong 1 2, Jamie 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
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.
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