Natural History of Non-Functioning Pituitary Adenomas: A Systematic Review and Meta-Analysis

The objective of this systematic review was to assess the risk of growth, new pituitary endocrinopathies, and surgery in patients with conservatively treated NFPTs. We conducted a bibliographical search identifying studies assessing NFPTs followed conservatively. Estimates were pooled using random-effects meta-analysis reporting events per 100 person years (PYs), in case of high heterogeneity (I2>75%) only the range of observed effects was reported. We identified 30 cohort studies including 1957 patients with a mean follow-up time of 4.0 (SD 1.5) years. The overall risk of tumor growth ranged from 0.0 to 14.2/100 PYs (I2=90%), while the overall risk of new endocrinopathies was 0.9/100 PYs (95% CI. 0.5 to 1.2; I2=35%) and risk of surgery ranged from 0.0 to 7.7/100 PYs (I2=80%). Compared to microadenomas, macroadenomas had higher risk of growth (p=0.002), higher risk of surgery (p=0.006), and non-significant differences in risk of new endocrinopathies (p=0.15). An analysis of microadenomas found the risk of growth to be 1.8/100 PYs (95% CI. 0.9 to 2.8; I2=58%), the risk of new endocrinopathies 0.7/100 PYs (95% CI. 0.0 to 1.6; I2=37%) and the risk of surgery 0.5/100 PYs (0.1 to 0.9; I2=37%). These data support individualized follow-up strategies of patients with NFP...
Source: Hormone and Metabolic Research - Category: Endocrinology Authors: Tags: Original Article: Endocrine Care Source Type: research