ArticleJournal of endocrinological investigation2025
Predictors of progression after surgery in non-functioning pituitary macroadenomas: a Spanish multicenter study.
Article in Journal of endocrinological investigation, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Predictors of in vitro response to somatostatin and dopamine receptor-targeted treatments are lacking in clinically non-functioning pituitary tumors.Journal of neuroendocrinology · 2026Article
- Exploring epigenome-proteome interactions underlying post-surgical progression of non-functioning pituitary adenomas using hypernetwork modelling.Journal of translational medicine · 2026Article
- Clinical, radiological, and pathological characteristics and long-term outcomes of silent corticotroph adenomas: a retrospective study.BMC endocrine disorders · 2025Article
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Authors and funding
36 authors.
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Abstract
background and purposeNon-functioning pituitary adenomas (NFPAs) have an unpredictable clinical course, with recurrence and progression posing significant challenges. This study aims to evaluate progression-free survival (PFS) and identify predictors and patterns of tumor progression.
methodsWe conducted a retrospective multicenter study including 472 patients with NFPAs > 1 cm from 17 Spanish hospitals (416 surgical, 56 conservative management). Tumor progression was defined as > 20% increase in size, >2 mm growth on imaging, or new/worsening clinical symptoms. Kaplan-Meier analysis was used to estimate PFS for both groups and independent predictors of progression were assessed using Cox proportional hazards regression in the surgical cohort.
resultsDuring a median follow-up of 7.9 years (range: 5.0-46.9), tumor progression occurred in 67 patients (14.2%). Most progression 29/67 (89.6%) events occurred within the first 15 years of follow-up. Multivariate analysis identified residual tumor (HR = 5.1; 95% CI: 2.2-11.9; p < 0.01) and aggressive histopathology (HR = 2.1; 95% CI: 1.1-3.8; p = 0.02) as significant independent predictors of progression. Neither gender, age, radiotherapy nor cabergoline treatment significantly altered progression risk in the multivariate model.
conclusionNFPAs show a gradual risk of progression over time, particularly during the first 15 years post-diagnosis. Postoperative residual tumor and aggressive histopathological features are the strongest predictors of progression, highlighting the importance of maximal safe resection when feasible and detailed histopathological assessment for risk stratification. These findings support long-term surveillance for high-risk patients.
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