TY - JOUR
T1 - Invasive adenoma and pituitary carcinoma
T2 - A SEER database analysis
AU - Hansen, Tara M.
AU - Batra, Sachin
AU - Lim, Michael
AU - Gallia, Gary L.
AU - Burger, Peter C.
AU - Salvatori, Roberto
AU - Wand, Gary
AU - Quinones-Hinojosa, Alfredo
AU - Kleinberg, Lawrence
AU - Redmond, Kristin J.
PY - 2014/4
Y1 - 2014/4
N2 - 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.
AB - 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.
KW - Invasive adenoma
KW - Pituitary carcinoma
KW - Pituitary tumor
KW - Survival
KW - Treatment
UR - http://www.scopus.com/inward/record.url?scp=84897075231&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84897075231&partnerID=8YFLogxK
U2 - 10.1007/s10143-014-0525-y
DO - 10.1007/s10143-014-0525-y
M3 - Article
C2 - 24526366
AN - SCOPUS:84897075231
SN - 0344-5607
VL - 37
SP - 279
EP - 286
JO - Neurosurgical Review
JF - Neurosurgical Review
IS - 2
ER -