Non-functioning pituitary adenoma database: a useful resource to improve the clinical management of pituitary tumors.
OBJECTIVE
The long-term outcome of non-functioning pituitary adenoma (NFPA) patients is not clearly established, probably due to the low annual incidence and prolonged natural history of these rare tumors. The aim of this study was to evaluate clinical data at presentation and long-term post-surgery and radiotherapy outcome in a cohort of patients with NFPA.


METHODS
A computerized database was developed using Access 2000 software (Microsoft Corporation, 1999). Retrospective registration of 295 NFPA patients was performed in seven Endocrinological Centers of North West Italy. Data were analyzed by STATA software.


RESULTS
The main presenting symptoms were visual defects (67.8%) and headache (41.4%) and the most frequent pituitary deficit was hypogonadism (43.3%), since almost all tumors were macroadenomas (96.5%). Surgery was the first choice treatment (98% of patients) and total debulking was achieved in 35.5%. Radiotherapy was performed as adjuvant therapy after surgery in 41% of patients. At the follow-up, recurrence occurred in 19.2% of patients without post-surgical residual tumor after 7.5 +/- 2.6 years, regrowth in 58.4% of patients with post-surgical remnant after 5.3 +/- 4.0 years and residue enlargement in 18.4% of patients post-surgically treated with radiotherapy after 8.1 +/- 7.3 years.


CONCLUSIONS
Our database indicates that the goal of a definitive surgical cure has been achieved during the last decade in a low percentage of patients with NFPA. This tumor database may help to reduce the delay between symptom onset and diagnosis, to assess prognostic parameters for the follow-up of patients with different risk of recurrence and to define the efficacy and safety of different treatments and their association with mortality/morbidity.
Ferrante
Emanuele
E
Endocrinology Unit, Department of Medical Sciences, University of Milan, Fondazione IRCCS Ospedale Maggiore, Policlinico, Mangiagalli e Regina Elena, Via F Sforza, 35, 20122 Milan, Italy.
Ferraroni
Monica
M
Castrignanò
Tristana
T
Menicatti
Laura
L
Anagni
Mascia
M
Reimondo
Giuseppe
G
Del Monte
Patrizia
P
Bernasconi
Donatella
D
Loli
Paola
P
Faustini-Fustini
Marco
M
Borretta
Giorgio
G
Terzolo
Massimo
M
Losa
Marco
M
Morabito
Alberto
A
Spada
Anna
A
Beck-Peccoz
Paolo
P
Lania
Andrea G
AG
D000236:Adenoma / Q000453:epidemiology* / Q000532:radiotherapy / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D016208:Databases, Factual / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D010911:Pituitary Neoplasms / Q000453:epidemiology* / Q000532:radiotherapy / Q000601:surgery*; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome; D014786:Vision Disorders / Q000453:epidemiology; D014794:Visual Fields