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Non-functioning pituitary macroadenoma: surgical outcomes, tumor regrowth, and alterations in pituitary function—3-year experience from the Iranian Pituitary Tumor Registry

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Abstract

Purpose

The aim of this study was to assess clinical features and therapeutic outcomes in patients with clinically non-functioning pituitary macroadenomas (NFPMAs).

Method

This is a retrospective cohort study of NFPMA patients treated surgically and followed periodically between 2015 and 2017 in a tertiary care center in Iran. Descriptive analysis was performed applying appropriate tests. Binary logistic regression models were used to determine the predictive factors for subtotal tumor resection (STR) and hormonal recovery. Data were analyzed by Stata software.

Result

A total of 71 patients with a mean age of 50.6 ± 1.4 years were studied. The mean diameter of the adenoma was 26.8 ± 1.1 mm. The most frequent symptoms were headache (85.75%), visual field defect (VFD) (78.3%), and hypogonadal symptoms (40.3%). Gross total resection (GTR) was achieved in 45.1%. Preoperative hypopituitarism was observed in 50.7% of patients. Recovery of at least one axis occurred in 36.1% of the patients suffering from hypopituitarism preoperatively, while new-onset postoperative hormonal deficiency appeared in 14.3% of patients. Multivariate analyses showing preoperative tumor size (OR = 38.2; P = 0.008) and cavernous sinus extension (OR = 13.4; P = 0.020) were predictors of STR. Moreover, hormonal recovery was observed not to be related to age, gender, tumor size, or the extent of tumor resection.

Conclusions

Tumor size and cavernous sinus extension are the main predictors for STR. Notably, recovery of the gonadal axis in a large proportion of patients supports the surgical resection of NFPAM in patients suffering from gonadal deficiency, even in the absence of VFD.

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Acknowledgements

We greatly appreciate the contribution of the staff of the Endocrine Research Center at Iran University of Medical Sciences (IUMS).

Funding

This study was funded and supported by Iran University of Medical Sciences (grant number 9511330002).

Author information

Authors and Affiliations

  1. Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences (IUMS), No. 10, Firoozeh St., Vali-asr Ave., Vali-asr Sq, Tehran, Iran

    Atousa Najmaldin, Nahid Hashemi Madani, Omolbanin Asadi Qadikolaei & Mohammad Ebrahim Khamseh

  2. Research Center for Prevention of Cardiovascular Disease, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran

    Mojtaba Malek

  3. Division of Vascular and Endovascular Neurosurgery, Firoozgar Hospital, Iran University of Medical Sciences (IUMS), Tehran, Iran

    Mohammad Ghorbani

  4. Golestan University of Medical Sciences, Gorgan, Iran

    Hamideh Akbari

  5. Student Research Committee, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Alireza Khajavi

Authors
  1. Atousa Najmaldin
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Corresponding author

Correspondence to Nahid Hashemi Madani.

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Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical approval

This study was approved by the ethics committee of Iran University of Medical Sciences (approval number: IR.IUMS.FMD.REC 1396.9511330002).

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

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We extracted data from a registry anonymously. Thus, inform consent was not necessary.

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Najmaldin, A., Malek, M., Madani, N.H. et al. Non-functioning pituitary macroadenoma: surgical outcomes, tumor regrowth, and alterations in pituitary function—3-year experience from the Iranian Pituitary Tumor Registry. Hormones 18, 197–205 (2019). https://doi.org/10.1007/s42000-019-00109-5

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