Usefulness of a clinicopathological classification in predicting treatment-related outcomes and multimodal therapeutic approaches in pituitary adenoma patients: retrospective analysis on a Portuguese cohort of 129 patients from a tertiary pituitary center

Purpose A clinicopathological classification has been designed to predict recurrence/progression in patients with pituitary adenomas (PAs). We aimed to study its usefulness in predicting PAs that will have a challenging disease course and may require more often complex multimodal and multiple therap...

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Published in:Pituitary 2023-08, Vol.26 (4), p.352-363
Main Authors: Peixe, Carolina, Alexandre, Maria Inês, Gomes, Ana Raquel, Nobre, Ema, Silva, Ana Luísa, Oliveira, Tiago, López-Presa, Dolores, Faria, Cláudia C., Miguens, José, Bugalho, Maria João, Marques, Pedro
Format: Article
Language:English
Subjects:
Acromegaly
Adenoma
Brain cancer
Classification
Endocrinology
Human Physiology
Magnetic resonance imaging
Medicine
Medicine & Public Health
Patients
Pituitary
Pituitary gland
Radiation therapy
Sinuses
Surgery
Tumors
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Summary:Purpose A clinicopathological classification has been designed to predict recurrence/progression in patients with pituitary adenomas (PAs). We aimed to study its usefulness in predicting PAs that will have a challenging disease course and may require more often complex multimodal and multiple therapeutic approaches. Methods Retrospective analysis of 129 patients with PAs operated in our institution between 2001 and 2020 (84 non-clinically functioning PAs, 32 acromegaly, 9 Cushing’s disease, 2 prolactinomas and 2 thyrotropinomas). Grading was based on invasion and proliferation: 1a (non-invasive, non-proliferative; n = 59), 1b (non-invasive, proliferative; n = 17), 2a (invasive, non-proliferative; n = 38), and 2b (invasive, proliferative; n = 15). Results Of the 129 patients, 68 (52.7%) were females, and the mean age at diagnosis was 53.7 ± 15.4 years. The mean follow-up duration was 93.1 ± 61.8 months. Grade 2b PAs when compared to other grades (2b-2a-1b-1a) had significantly higher rates of persistent tumor remnant within 1-year after operation (93–78-18–30%; p 
ISSN:1386-341X
1573-7403
DOI:10.1007/s11102-023-01319-2