title: Pituitary disease mortality: is it fiction?
abstract: During the last 20 years a tremendous improvement in the care of patients with pituitary tumors and of hypopituitarism has been achieved. If we resolve most of the possible causes of the increased cardiovascular disease and stroke mortality a normal survival is expected in these patients. Recently, a large population based study showed a decline in the risk of non-fatal stroke and of non-fatal cardiac events in GH deficient patients. This improvement was achieved by complete hormone replacement, including long term GH replacement, together with prescription of cardio protective drugs. If we follow the latest achievements in pituitary imaging, surgery techniques, hormone substitutions, cardio protective medications, we would expect a normal longevity in these patients. This review will focus on; (1) pituitary insufficiencies and hormone substitutions, (2) modes of cranial radiotherapy, and (3) new techniques in the surgery of a pituitary adenoma.
authors: Department of Endocrinology, Skånes University Hospital, 221 85, Lund, Sweden. eva_marie.erfurth@med.lu.se
authors: Eva Marie
authors: EM
authors: Erfurth
authors: Peter
authors: P
authors: Siesjö
authors: Thomas
authors: T
authors: Björk-Eriksson
mesh_terms: D002318:Cardiovascular Diseases / Q000401:mortality; D004724:Endoscopy; D005260:Female; D019382:Human Growth Hormone / Q000172:deficiency / Q000378:metabolism*; D006801:Humans; D007018:Hypopituitarism / Q000401:mortality; D008297:Male; D010900:Pituitary Diseases / Q000188:drug therapy / Q000401:mortality* / Q000532:radiotherapy; D010911:Pituitary Neoplasms / Q000601:surgery; D020521:Stroke / Q000401:mortality
chemical_list: D019382:Human Growth Hormone
references: Clin Endocrinol (Oxf). 2011 Apr;74(4):481-7
references: 21133979
references: Neurosurg Focus. 2007;23(3):E7
references: 17961019
references: Neurosurgery. 2000 Jan;46(1):138-49; discussion 150-1
references: 10626944
references: Pituitary. 2005;8(2):93-7
references: 16195777
references: Br J Neurosurg. 2012 Feb;26(1):59-63
references: 22122708
references: Radiother Oncol. 2012 Jul;104(1):125-30
references: 22682541
references: Int J Radiat Oncol Biol Phys. 2001 Aug 1;50(5):1279-86
references: 11483339
references: Lancet. 2001 Feb 10;357(9254):425-31
references: 11273062
references: J Clin Endocrinol Metab. 2004 Jul;89(7):3306-12
references: 15240607
references: Neurosurg Rev. 2007 Jul;30(3):167-75; discussion 175-6
references: 17483973
references: Eur J Endocrinol. 2007 Jul;157(1):9-18
references: 17609396
references: Int J Radiat Oncol Biol Phys. 2006 Feb 1;64(2):425-34
references: 16257131
references: Br J Cancer Suppl. 1986;7:181-91
references: 3521701
references: J Neurosurg. 2009 Sep;111(3):545-54
references: 19199461
references: Acta Endocrinol (Copenh). 1993 Sep;129(3):195-200
references: 8212983
references: Lancet. 1990 Aug 4;336(8710):285-8
references: 1973979
references: Acta Neurochir (Wien). 2007;149(9):877-85; discussion 885-6
references: 17616842
references: Q J Med. 1991 Dec;81(296):985-98
references: 1808643
references: Best Pract Res Clin Endocrinol Metab. 2009 Oct;23(5):677-92
references: 19945031
references: J Clin Endocrinol Metab. 1999 Apr;84(4):1329-33
references: 10199774
references: J Clin Endocrinol Metab. 2011 Jun;96(6):1587-609
references: 21602453
references: Laryngoscope. 2012 Mar;122(3):511-8
references: 22252670
references: J Clin Endocrinol Metab. 2007 Sep;92(9):3560-7
references: 17623762
references: J Neurosurg. 1991 May;74(5):695-700
references: 2013769
references: Eur J Endocrinol. 2003 Dec;149(6):511-9
references: 14640991
references: Clin Endocrinol (Oxf). 2002 Apr;56(4):493-501
references: 11966742
references: Ann Intern Med. 2000 Jul 18;133(2):111-22
references: 10896637
references: Clin Endocrinol (Oxf). 2007 Apr;66(4):459-65
references: 17371460
references: Clin Endocrinol (Oxf). 1999 Jan;50(1):45-55
references: 10341855
references: JAMA. 2004 Apr 14;291(14):1701-12
references: 15082697
references: Arch Neurol. 1989 Apr;46(4):449-55
references: 2650664
references: Am J Physiol Endocrinol Metab. 2005 Aug;289(2):E266-71
references: 15727949
references: J Clin Endocrinol Metab. 2010 Aug;95(8):3726-35
references: 20484480
references: Rev Endocr Metab Disord. 2009 Jun;10(2):135-44
references: 18787957
references: J Clin Invest. 1996 Dec 15;98(12):2706-13
references: 8981915
references: Lancet. 1990 Mar 31;335(8692):765-74
references: 1969518
references: Clin Endocrinol (Oxf). 1997 Mar;46(3):263-8
references: 9156032
references: J Clin Endocrinol Metab. 2002 Nov;87(11):4892-9
references: 12414846
references: Clin Endocrinol (Oxf). 2007 Nov;67(5):693-7
references: 17634076
references: AJNR Am J Neuroradiol. 1997 Apr;18(4):655-65
references: 9127026
references: Neurol Res. 1987 Jun;9(2):60-8
references: 2886946
references: Clin Endocrinol (Oxf). 2002 Dec;57(6):713-7
references: 12460319
references: J Clin Endocrinol Metab. 2012 Feb;97(2):473-81
references: 22112807
references: J Clin Endocrinol Metab. 1999 Feb;84(2):453-7
references: 10022400
references: Neurosurgery. 2003 Feb;52(2):309-16; discussion 316-7
references: 12535358
references: J Clin Endocrinol Metab. 2002 Aug;87(8):3650-5
references: 12161490
references: J Clin Endocrinol Metab. 1997 Feb;82(2):550-5
references: 9024252
references: Neurosurgery. 2012 Sep;71(1 Suppl Operative):173-80; discussion 180-1
references: 22249952
references: Int J Radiat Oncol Biol Phys. 2007 Jan 1;67(1):232-9
references: 17084541
references: World Neurosurg. 2011 Jul-Aug;76(1-2):141-8; discussion 63-6
references: 21839965
references: J Clin Endocrinol Metab. 2006 Oct;91(10):3954-61
references: 16895963
references: J Clin Endocrinol Metab. 2009 Nov;94(11):4216-23
references: 19808848
references: J Cardiovasc Pharmacol. 1989;13 Suppl 1:S4-10
references: 2468976
references: J Clin Endocrinol Metab. 2011 Oct;96(10):3151-9
references: 21849531
references: Front Horm Res. 2006;35:115-128
references: 16809927
references: Pituitary. 2008;11(4):375-84
references: 18421581
references: J Clin Endocrinol Metab. 2003 Sep;88(9):4031-42
references: 12970259
references: Neurosurgery. 1997 Feb;40(2):225-36; discussion 236-7
references: 9007854
references: J Clin Endocrinol Metab. 2002 May;87(5):2121-7
references: 11994351
references: Clin Endocrinol (Oxf). 1997 Jan;46(1):75-81
references: 9059561
references: J Clin Endocrinol Metab. 1989 Dec;69(6):1127-32
references: 2685007
references: Eur J Endocrinol. 2012 Feb;166(2):171-9
references: 22071311
references: Eur J Endocrinol. 2005 Mar;152(3):379-87
references: 15757854
references: J Clin Endocrinol Metab. 2004 May;89(5):2192-9
references: 15126541
references: Pituitary. 2011 Sep;14(3):276-83
references: 21476061
references: J Clin Endocrinol Metab. 1988 Nov;67(5):1111-4
references: 3182961
references: Clin Endocrinol (Oxf). 2012 Mar;76(3):328-31
references: 22107606
references: JAMA. 2011 Apr 6;305(13):1305-14
references: 21467283
references: J Otolaryngol Head Neck Surg. 2011 Apr;40(2):175-85
references: 21453654
references: Br J Neurosurg. 2010 Feb;24(1):31-9
references: 20158350
references: J Clin Endocrinol Metab. 2002 May;87(5):2042-5
references: 11994338
references: Strahlenther Onkol. 2002 Apr;178(4):173-86
references: 12040754
references: Eur J Endocrinol. 2006 Jul;155(1):79-90
references: 16793953