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Impact of age on postsurgical outcomes of nonfunctioning pituitary adenomas
- Source :
- Endocrine. 72:915-922
- Publication Year :
- 2020
- Publisher :
- Springer Science and Business Media LLC, 2020.
-
Abstract
- The management of pituitary adenomas in the elderly has become a relevant clinical issue, in relationship with improved life expectancy and spreading use of imaging techniques. In this single-center and retrospective study, we investigated the impact of age on peri- and postsurgical outcomes in patients undergoing transnasal sphenoidal (TNS) surgery for pituitary adenomas. One-hundred-sixty-nine patients (62% males) undergoing endoscopic transphenoidal (TNS) surgery for nonfunctioning pituitary adenomas (NFPAs) were enrolled. Patients were subdivided into three groups according to age tertiles: ≤56 (group 1), 57–69 (group 2), and ≥70 (group 3) years. Postsurgical and endocrinological outcomes were evaluated and compared among the three age groups. 37/169 patients (21.9%) developed at least one perisurgical complication, without significant association with the patients’ age (P = 0.838), Charlson co-morbidity score (P = 0.326), and American Society of Anesthesiologist score (P = 0.616). In the multivariate regression analysis, the adenoma size resulted the only determinant of perisurgical complication (odds ratio [OR] 1.07, 95% confidence interval [C.I.] 1.00–1.13; P = 0.044). The development and the recovery of at least one pituitary hormone deficiency were observed in 12.2% and 14.2% of patients, respectively. The risk of developing new pituitary hormone deficiencies was correlated with cavernous sinus invasion as evaluated by magnetic resonance imaging (hazard ratio [HR] 4.19, 95% C.I. 1.39–12.66; P = 0.010), whereas the probability to normalize at least one pituitary hormone deficiency was significantly correlated with younger age of patients (HR 0.27, 95% CI 0.12–0.61; P = 0.002). The results of this study reinforce the concept that endoscopic TNS surgery is a safe therapeutic option in the elderly patients with NFPA, even in presence of comorbidities and high anesthetic risk.
- Subjects :
- medicine.medical_specialty
Adenoma
medicine.diagnostic_test
business.industry
Endocrinology, Diabetes and Metabolism
Hazard ratio
030209 endocrinology & metabolism
Magnetic resonance imaging
Retrospective cohort study
Odds ratio
medicine.disease
Gastroenterology
Confidence interval
03 medical and health sciences
0302 clinical medicine
Endocrinology
030220 oncology & carcinogenesis
Internal medicine
Cavernous sinus
medicine
Complication
business
Subjects
Details
- ISSN :
- 15590100 and 1355008X
- Volume :
- 72
- Database :
- OpenAIRE
- Journal :
- Endocrine
- Accession number :
- edsair.doi...........dbdceca4ef4ac64ebf2ef9329d5d48bc