ArticleThe Journal of clinical endocrinology and metabolism2025
Validation and Limitations of the PANOMEN-3 Predictive Model for Tumor Recurrence and Progression in Pituitary Tumors.
Article in The Journal of clinical endocrinology and metabolism, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Approach to the patient: precision medicine-guided evaluation and treatment of acromegaly.The Journal of clinical endocrinology and metabolism · 2026Review
- Association between preoperative MRI radiomic features and methylation-defined phenotypes in non-functioning pituitary adenomas.Pituitary · 2026Article
- Can acromegaly be controlled in all cases?Journal of neuroendocrinology · 2026Review
- External validation of the PANOMEN-3 classification for predicting 1-year surgical remission in pituitary adenoma.Pituitary · 2026Article
- Prognostic value of PANOMEN-3 classification for hypopituitarism in surgically and nonoperatively managed pituitary adenomas.Endocrine connections · 2026Article
- Observational
Corrections and comments
- Erratum issued
Authors and funding
36 authors.
Funding
Abstract
contextIt has been proposed that the PANOMEN-3 classification may be useful to guide the prognosis and therapy of patients with pituitary tumors (PTs). However, the model has not yet been validated to date in order to assess its usefulness in routine clinical practice.
objectiveThe aim of our study was to validate the classification proposed by the PANOMEN-3 group for the prediction of tumor recurrence/progression in PTs.
methodsMulticenter national case-control study of patients with PTs followed for at least 5 years. Kaplan-Meier curves were used to assess the time to tumor recurrence/progression. Univariate and multivariate Cox regression analyses were used to estimate the hazard ratio (HR) and prognostic capacity of the classification proposed by the PANOMEN-3 group.
resultsA total of 1143 patients were included. Pituitary surgery was performed in 814 patients and the remaining 329 patients were followed with active surveillance or medical treatment. After a median follow-up of 8.8 years (5-29.8), 253 patients experienced tumor recurrence or biochemical/radiological progression and were classified as cases. The other 890 patients were classified as controls. The mean follow-up from PT diagnosis to recurrence was 7.2 ± 5.4 years. The diagnostic accuracy of the PANOMEN-3 model to predict recurrence/progression was 75.6% (95% CI 0.716-0.796). Residual tumor (HR 2.20, P < .001), a hereditary syndrome (HR 5.15, P = .026), and active secretory status (HR 1.80, P = .021) were the most important variables in this model. Recurrence/progression rate increased with increasing PANOMEN-3 grade (2.5% in grade 0; 10.3% in grade 1, 33.7% in grade 2, and 33.3% in grade 3; P < .001).
conclusionThe predictive model proposed by the PANOMEN-3 group may be useful to guide the prognosis and therapy of PTs in the Spanish population since it offers a good accuracy to predict tumoral/biochemical recurrence and/or progression in operated and nonoperated patients.
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