Evidence map›Paper›PMID 37389717›Full record

ArticleEndocrine2023

Pituitary function at presentation and following therapy in patients with non-functional pituitary macroadenomas: a single centre retrospective cohort study.

Ziad Hussein, Hani J Marcus, Joan Grieve, Neil Dorward, Michael Kosmin, Naomi Fersht, Pierre Marc Bouloux, Zane Jaunmuktane, Stephanie E Baldeweg

Open access · hybridAbstract read
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In one paragraph

Article in Endocrine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
1.8field-weighted citation impact, top 14% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 9 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 5 institutions in 2 countries.

Ziad HusseinDepartment of Diabetes and Endocrinology, Sheffield Teaching Hospitals, Sheffield, UK. ziad.hussein1@nhs.net.ORCID 0000-0002-9129-853X
Hani J MarcusDepartment of Neurosurgery, National Hospital for Neurology and Neurosurgery, London, UK.
Joan GrieveDepartment of Neurosurgery, National Hospital for Neurology and Neurosurgery, London, UK.
Neil DorwardDepartment of Neurosurgery, National Hospital for Neurology and Neurosurgery, London, UK.
Michael KosminDepartment of Clinical Oncology, University College London Hospitals, London, UK.
Naomi FershtDepartment of Clinical Oncology, University College London Hospitals, London, UK.
Pierre Marc BoulouxCentre for Neuroendocrinology, Royal Free Campus, University College Medical School, University College London, London, UK.
Zane JaunmuktaneInstitute of Neurology, University College London, London, UK.
Stephanie E BaldewegDivision of Medicine, University College London, London, UK.
National Hospital for Neurology and Neurosurgery · GBRoyal London Hospital · GBThe Royal Free Hospital · GBUniversity College London · GBUniversity College London Hospitals NHS Foundation Trust · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundNon-functioning pituitary macroadenomas (NFPMs) may present with hypopituitarism. Pituitary surgery and radiotherapy pose an additional risk to pituitary function.

objectivesTo assess the incidence of hypopituitarism at presentation, the impact of treatment, and the likelihood of endocrine recovery during follow-up.

methodsAll patients treated surgically with and without radiotherapy for NFPMs between 1987 and 2018 who had longer than six months follow-up were identified. Demographics, presentation, investigation, treatment, and outcomes were collected.

resultsIn total, 383 patients were identified. The median age was 57 years, with a median follow-up of 8 years. Preoperatively, 227 patients (227/375; 61%) had evidence of at least one pituitary deficiency. Anterior panhypopituitarism was more common in men (p = 0.001) and older patients (p = 0.005). Multiple hormone deficiencies were associated with large tumours (p = 0.03). Patients treated with surgery and radiotherapy had a higher incidence of all individual pituitary hormone deficiency, anterior panhypopituitarism, and significantly lower GH, ACTH, and TSH deficiencies free survival probability than those treated with surgery alone. Recovery of central hypogonadism, hypothyroidism, and anterior panhypopituitarism was also less likely to be reported in those treated with surgery and radiotherapy. Those with preoperative hypopituitarism had a higher risk of pituitary impairment at latest review than those presented with normal pituitary function (p = 0.001).

conclusionNFPMs are associated with a significant degree of hypopituitarism at time of diagnosis and post-therapy. The combination of surgery and radiotherapy is associated with a higher risk of pituitary dysfunction. Recovery of pituitary hormone deficit may occur after treatment. Patients should have regular ongoing endocrine evaluation post-treatment to assess changes in pituitary function and the need for long-term replacement therapy.

Indexed as

HypopituitarismHypothyroidismPituitary NeoplasmsHumansMaleMiddle AgedPituitary GlandPituitary HormonesRetrospective StudiesPituitary HormonesHypopituitarismNon-functioning Pituitary AdenomaRadiotherapyTranssphenoidal Surgery

Identifiers

PMID37389717
PMCPMC10462492
OpenAlexW4382631201

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.