Longitudinal Monitoring of the Growth of Post-Operation Non-Functioning Pituitary Adenomas


Authors: T. Česák 1;  J. Náhlovský 1;  T. Hosszú 1;  S. Řehák 1;  I. Látr 1;  S. Němeček 1,2;  J. Čáp 3;  P. Ryška 4;  P. Šuba 1,5;  J. Cerman 5,1
Authors‘ workplace: LF UK v Hradci Králové a FN Hradec Králové: 1Ne urochirurgická klinika, 2Ústav histologi e a embryologi e, 3II. interní klinika, 4Radi odi agnostická klinika, 5Ústav lékařské bi ochemi e
Published in: Cesk Slov Neurol N 2009; 72/105(2): 115-124
Category: Original Paper

Overview

Objective:
Non-functioning pituitary adenomas (NFPAs) are regarded as benign, slowly growing tumors. However, aggressive proliferation is not exceptional, especially in younger patients. The aim of the study was to investigate the natural growth patterns of NFPAs and to identify the factors affecting volume progression. As part of the study, nuclear marker Ki-67 was tested as a potentially reliable indicator of postoperative remnant growth potential.

Material:
The study is based on 105 patients operated for NFPAs between 2000 and 2007. The criteria for the inclusion in the study were met by 29 patients (22 men, 7 women).

Results:
The extent of resection was approximately 75 % of the preoperative volume. Tumor consistency was not a limiting factor for the radicality of resection. Factors such as sex, presence of a cyst or invasive growth did not prove to have any significant effect on the level of radicality. Growth curves proved a statistically significant dependence of the rate of growth on the patient’s age. No correlation was found between the rate of growth and the Ki-67 proliferation index. Similarly, no relationship between the rate of growth, tumor invasiveness, sex and the presence of a cyst was observed. Invasiveness was not associated with higher Ki-67 values.

Conclusion:
Based on the results, the following conclusions can be drawn: the rate of NFPAs growth depends on the patient’s age. This fact is useful for treatment strategy as well as postoperative monitoring. The Ki-67 proliferation marker, well-established in human oncology, cannot be considered as a reliable predictive marker of NFPAs growth in our recent study.

Key words:
non‑functi oning pituitary adenomas –  postoperative tumo ur remnant/ recurrence –  proliferating marker Ki‑67


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