Invasive adenoma and pituitary carcinoma: a SEER database analysis

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• 作者：Tara M. Hansen (1)
  Sachin Batra (2)
  Michael Lim (2) (3) (4)
  Gary L. Gallia (2) (3)
  Peter C. Burger (5)
  Roberto Salvatori (6)
  Gary Wand (6)
  Alfredo Quinones-Hinojosa (2)
  Lawrence Kleinberg (7)
  Kristin J. Redmond (7)
  
• 关键词：Pituitary tumor ; Pituitary carcinoma ; Invasive adenoma ; Treatment ; Survival
• 刊名：Neurosurgical Review
• 出版年：2014
• 出版时间：April 2014
• 年：2014
• 卷：37
• 期：2
• 页码：279-286
• 全文大小：257 KB
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• 作者单位：Tara M. Hansen (1)
  Sachin Batra (2)
  Michael Lim (2) (3) (4)
  Gary L. Gallia (2) (3)
  Peter C. Burger (5)
  Roberto Salvatori (6)
  Gary Wand (6)
  Alfredo Quinones-Hinojosa (2)
  Lawrence Kleinberg (7)
  Kristin J. Redmond (7)
  
  1. Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
  2. Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
  3. Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
  4. Department of Radiation Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
  5. Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
  6. Division of Endocrinology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
  7. Department of Radiation Oncology and Molecular Radiation Sciences, Johns Hopkins University School of Medicine, 401 North Broadway, Suite 1440, Baltimore, MD, 21231, USA
  
• ISSN：1437-2320

文摘

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--.047, 0.001, and 0.009). Only non-white race, male gender, and age ?5 were significant negative prognostic factors for invasive adenomas (p--.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--.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.