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: Rikvold, Stefan Dukanovic Pedersen, Mathias Brown Andreassen, Mikkel Krogh, Jesper Tags: Original Article: Endocrine Care Source Type: research