TY - JOUR

T1 - Natural History of Non-Functioning Pituitary Adenomas

T2 - A Systematic Review and Meta-Analysis

AU - Rikvold, Stefan Dukanovic

AU - Pedersen, Mathias Brown

AU - Andreassen, Mikkel

AU - Krogh, Jesper

N1 - Publisher Copyright: © 2023 Georg Thieme Verlag. All rights reserved.

PY - 2023

Y1 - 2023

N2 - The management of non-functioning pituitary tumors (NFPTs) relies on the risk of tumor growth and new endocrinopathies. 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 NFPTs and particularly a less rigorous follow-up of patients with microadenomas.

AB - The management of non-functioning pituitary tumors (NFPTs) relies on the risk of tumor growth and new endocrinopathies. 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 NFPTs and particularly a less rigorous follow-up of patients with microadenomas.

KW - endocrinopathies

KW - natural history

KW - non-functioning pituitary tumors

KW - PitNets

UR - http://www.scopus.com/inward/record.url?scp=85165672621&partnerID=8YFLogxK

U2 - 10.1055/a-2096-1340

DO - 10.1055/a-2096-1340

M3 - Review

C2 - 37494058

AN - SCOPUS:85165672621

VL - 55

SP - 443

EP - 451

JO - Hormone and Metabolic Research. Supplement

JF - Hormone and Metabolic Research. Supplement

SN - 0170-5903

IS - 7

ER -