title: Invasive adenoma and pituitary carcinoma: a SEER database analysis.
abstract: Invasive pituitary adenomas and pituitary carcinomas are clinically indistinguishable until identification of metastases. Optimal management and survival outcomes for both are not clearly defined. The purpose of this study is to use the Surveillance, Epidemiology, and End Results (SEER) database to report patterns of care and compare survival outcomes in a large series of patients with invasive adenomas or pituitary carcinomas. One hundred seventeen patients diagnosed between 1973 and 2008 with pituitary adenomas/adenocarcinomas were included. Eighty-three invasive adenomas and seven pituitary carcinomas were analyzed for survival outcomes. Analyzed prognostic factors included age, sex, race, histology, tumor extent, and treatment. A significant decrease in survival was observed among carcinomas compared to invasive adenomas at 1, 2, and 5 years (p = 0.047, 0.001, and 0.009). Only non-white race, male gender, and age ≥65 were significant negative prognostic factors for invasive adenomas (p = 0.013, 0.033, and <0.001, respectively). There was no survival advantage to radiation therapy in treating adenomas at 5, 10, 20, or 30 years (p = 0.778, 0.960, 0.236, and 0.971). In conclusion, pituitary carcinoma patients exhibit worse overall survival than invasive adenoma patients. This highlights the need for improved diagnostic methods for the sellar phase to allow for potentially more aggressive treatment approaches.
authors: Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, IN, 46202, USA.
authors: Tara M
authors: TM
authors: Hansen
authors: Sachin
authors: S
authors: Batra
authors: Michael
authors: M
authors: Lim
authors: Gary L
authors: GL
authors: Gallia
authors: Peter C
authors: PC
authors: Burger
authors: Roberto
authors: R
authors: Salvatori
authors: Gary
authors: G
authors: Wand
authors: Alfredo
authors: A
authors: Quinones-Hinojosa
authors: Lawrence
authors: L
authors: Kleinberg
authors: Kristin J
authors: KJ
authors: Redmond
mesh_terms: D000236:Adenoma / Q000601:surgery*; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D010911:Pituitary Neoplasms / Q000473:pathology / Q000601:surgery*; D011379:Prognosis; D016896:Treatment Outcome