ECE2015 Eposter Presentations Pituitary: clinical (121 abstracts)
Mortality of patients with non-functioning pituitary macroadenoma is significantly elevated: systematic analysis of 546 cases in a tertiary referral centre in the UK
Georgia Ntali 1 , Cristina Capatina 1 , Violet Fazal-Sanderson 1 , James V Byrne 2 , Simon Cudlip 3 , John Ah Wass 1 , Ashley B Grossman 1 & Niki Karavitaki 1
1Department of Endocrinology, Oxford Centre for Diabetes, Endocrinology and Metabolism, Churchill Hospital, Oxford, UK; 2Department of Neuroradiology, John Radcliffe Hospital, Oxford, UK; 3Department of Neurosurgery, John Radcliffe Hospital, Oxford, UK.
Introduction: Data on the mortality of patients with non-functioning pituitary macroadenoma (NFA) are very limited.
Aim: To assess the mortality of patients with NFA and factors predicting it.
Patients and methods: All patients presenting to our department with NFA between 1963 and 2011 were studied. Status was recorded as either dead or alive, as of 31st December 2011.
Results: 546 patients (333 males) were identified (median age at surgery 58.7 years; range 16.1–94.2). Data on mortality were available for all patients covering a median period of 8 years (range 1 month–48.5 years); 83 patients died (median age 77.8 years; range 36.4–98.3) (causes: cardio/cerebrovascular 32.5%, infections 30.1%, malignancies 28.9%, peri-operatively 1.2%, gastrointestinal hemorrhage 1.2%, suicide 1.2%, unknown 3.6%, and old age 1.2%). The SMR for the total group was 3.62 (95% CI: 2.90–4.47; P<0.001), for those diagnosed before 1990 4.66 (95% CI: 2.65–7.63; P<0.001) and for those after 1990 3.53 (95% CI: 2.77–4.44; P<0.001). Clinical follow-up data (until date of death or date the database was frozen) were available for 436 patients (269 males, median age at surgery 58.5 years (range 16.11–94.19), 203/431 with no or intrasellar remnant – 228/431 with extrasellar remnant after surgery, median follow-up 6.9 years (range 1 month–48.5 years), 111/436 with regrowth of NFA, 188/436 received radiotherapy after primary surgery or for regrowth). Cox regression analysis (univariate approach) demonstrated that amongst age at surgery, NFA regrowth, radiotherapy, sex and extent of removal, the first three were significant predictors of mortality; after multivariate analysis using these three parameters, only age remained an independent significant factor (HR 1.099, 95% CI: 1.073–1.126; P<0.001).
Conclusions: Despite the improvement in the last three decades, mortality of patients with NFA remains high. Apart from age, factors related with the management/outcome of the tumour including radiotherapy and recurrence are not independent predictors of mortality in this group of patients.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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