Comparing progression of non-functioning pituitary adenomas in hypopituitarism patients with and without long-term GH replacement therapy.
OBJECTIVE
An important safety issue with GH replacement therapy (GHRT) in hypopituitary patients with a history of a pituitary adenoma is the risk for tumour recurrence or enlargement. Design Case-control study.


METHODS
We studied tumour progression rate in 121 patients with hypopituitarism on the basis of non-functioning pituitary adenomas (NFPA) receiving long-term GHRT. A group of 114 NFPA patients not receiving GHRT who were matched in terms of duration of follow-up, gender, age, age at diagnosis and radiotherapy status were used as a control population. The average duration of GHRT was 10+/-4 years (range 2-17).


RESULTS
In patients with a known residual adenoma, 63% had no detectable enlargement of tumour during the study. In patients who had no visible residual tumour prior to GHRT, 90% did not suffer from recurrence. In total, the 10-year tumour progression-free survival rate in patients with NFPA receiving GHRT was 74%. In the control population not receiving GHRT, the 10-year progression-free survival rate was 70%. Radiotherapy as part of the initial tumour treatment reduced the rate of tumour progression in both GHRT and non-GHRT patients to a similar extent.


CONCLUSIONS
The rate of tumour progression was similar in this large group of GHRT patients and the control population not receiving GHRT. Our results provide further support that long-term use of GH replacement in hypopituitarism may be considered safe in patients with residual pituitary adenomas.
Olsson
D S
DS
Department of Endocrinology, Sahlgrenska University Hospital, SE-413 45 Gothenburg, Sweden.
Buchfelder
M
M
Schlaffer
S
S
Bengtsson
B-A
BA
Jakobsson
K-E
KE
Johannsson
G
G
Nilsson
A G
AG
D000236:Adenoma / Q000473:pathology* / Q000628:therapy; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D018450:Disease Progression; D005260:Female; D020249:Hormone Replacement Therapy / Q000009:adverse effects* / Q000379:methods*; D019382:Human Growth Hormone / Q000008:administration & dosage*; D006801:Humans; D007018:Hypopituitarism / Q000188:drug therapy* / Q000473:pathology*; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D053208:Kaplan-Meier Estimate; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D010911:Pituitary Neoplasms / Q000188:drug therapy / Q000473:pathology*; D011446:Prospective Studies
D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I