title: Clinical course and outcome of nonfunctioning pituitary adenomas in the elderly compared with younger age groups.
abstract: OBJECTIVE
  Nonfunctioning pituitary adenomas (NFPAs) are the most common type of pituitary adenomas diagnosed in older patients. However, there are insufficient data regarding the clinical course, risk of regrowth, and long-term prognosis in elderly versus younger patients.
  
  
  METHODS
  This retrospective cohort study observed 105 adult patients with NFPAs diagnosed between 1995 and 2012. Patients were stratified into 3 age groups: 18 to 44 years (29 patients), 45 to 64 years (38 patients), and 65 years and over (38 patients). The impact of age on presenting symptoms, disease course, and outcome was analyzed.
  
  
  RESULTS
  Adenoma size was larger in patients <45 years (mean, 2.9 ± 1.2 cm) compared to patients aged 45 to 64 years and those ≥65 years old (2.3 ± 0.9 and 2.5 ± 0.8 cm, respectively; P = .05), with transsphenoidal surgery being the treatment of choice in all 3 groups (83, 92, and 84%, not significant). After a mean follow-up of 6 years, there were higher recovery rates from hypopituitarism in patients <45 years old (58% vs. 27% and 24%; P = .04). Visual fields improved in most affected patients in each group following surgery (74, 94, and 86%), with a trend toward more full normalization in the youngest age group (58% vs. 44% and 41%; P = .09). There were no significant differences in the risk of remnant growth (29 to 39%), rates of radiation therapy, or need for repeated surgeries. There was no disease-related mortality.
  
  
  CONCLUSIONS
  Elderly patients with NFPA have lower rates of recovery from hypopituitarism after treatment compared to younger patients, but the rates of regrowth and need for salvage surgery are similar.
authors.affiliation: Endocrinology & Metabolism Institute, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Eyal
authors.initials: E
authors.lastname: Robenshtok
authors.affiliation: Endocrinology & Metabolism Institute, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Benbassat
authors.affiliation: Endocrinology & Metabolism Institute, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Dania
authors.initials: D
authors.lastname: Hirsch
authors.affiliation: Endocrinology & Metabolism Institute, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel.
authors.forename: Gloria
authors.initials: G
authors.lastname: Tzvetov
authors.affiliation: Department of Neurosurgery, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Zvi R
authors.initials: ZR
authors.lastname: Cohen
authors.affiliation: Endocrinology & Metabolism Institute, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel.
authors.forename: Hiba Masri
authors.initials: HM
authors.lastname: Iraqi
authors.affiliation: Endocrinology & Metabolism Institute, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Alexander
authors.initials: A
authors.lastname: Gorshtein
authors.affiliation: Endocrinology & Metabolism Institute, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel.
authors.forename: Yoel
authors.initials: Y
authors.lastname: Toledano
authors.affiliation: Endocrinology & Metabolism Institute, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Ilan
authors.initials: I
authors.lastname: Shimon
mesh_terms: D000236:Adenoma / Q000503:physiopathology / Q000628:therapy*; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010911:Pituitary Neoplasms / Q000503:physiopathology / Q000628:therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult