Endocrine Abstracts

Introduction: In 2013 Trouillas et al. reported a new prognostic clinicopathological classification of pituitary adenomas. This classification analyses the impact of the intensity of proliferation and invasiveness of the tumor on patients’ prognosis. The aim of the study was to review this new classification in giant pituitary adenomas (GPAs) treated with endoscopic transsphenoidal approach.

Material and methods: The study is a retrospective analysis of a series of 176 patients (66 women and 110 men) treated from the 2007 to 2023 by the endoscopic transsphenoidal surgeries for GPAs (>40mm). The mean age of the patients was 57.0 years (20-81 years), and the mean follow up period was 7.5 years (0-16 years). The patients were divided into the control group without the evidence of disease (EoD) and the study group with EoD.

Results: In the group with EoD the most commonly observed were grade 2a tumors (71.7%), followed by grade 1a (13.3%), 2b (12.4%), and 1b (2.7%). In the control group (with favorable outcomes – no EoD) grades 2a and 1a were reported in similar numbers of patients (46.0% and 41.3% respectively), followed by grade 2b and 1b (both observed in 6.3% of patients). Overall, more invasive or proliferative tumors classified either as grade 2a or 2b were observed in the group with EoD (OR=2.97 and OR=2.09 respectively, P<0.001).

Conclusion: Our results indicate that the new classification proposed by Trouillas et al. is a reliable tool in predicting prognosis of patients with GPAs.