Factors affecting hormonal outcomes in patients undergoing surgery for non-functioning pituitary neuroendocrine tumors: a prospective observational study
Surgical resection of non-functioning pituitary neuroendocrine tumors (NF-PitNET) is associated with new onset hormonal axis (HA) dysfunction, and factors predicting HA dysfunction are controversial, especially in large and giant NF-PitNET. Thus, we evaluated the postoperative hormonal function and...
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| Veröffentlicht in: | Neurosurgical review 2024-12, Vol.48 (1), p.4, Article 4 |
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| description | Surgical resection of non-functioning pituitary neuroendocrine tumors (NF-PitNET) is associated with new onset hormonal axis (HA) dysfunction, and factors predicting HA dysfunction are controversial, especially in large and giant NF-PitNET. Thus, we evaluated the postoperative hormonal function and assessed factors affecting HA dysfunction in patients with NF-PitNET. This prospective observational study involved 50 patients who underwent endoscopic surgical resection of NF-PitNET in the Department of Neurosurgery (April 2023–March 2024). The preoperative tumor diameter and volume were calculated radiologically. Hormonal evaluation was performed preoperatively, and again postoperatively at 7-days and 90-days. At 90-days, 36% patients recovered HA function, 34% remained unchanged, while 30% worsened. Serum cortisol (
p
0.05). Overall, there was no significant change in grade of HA dysfunction (
p
> 0.05). Male sex (OR:5.630, 95%CI:1.648–19.232;
p
= 0.006), tumor volume (OR:3.511, 95%CI:1.308–9.423;
p
= 0.013) and tumor diameter (OR:9.489, 95%CI:2.916–30.878;
p
|
| doi_str_mv | 10.1007/s10143-024-03150-0 |
| format | Article |
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p
< 0.0001), adrenocorticotropic hormone (
p
= 0.012), growth hormone (
p
= 0.013), and luteinizing hormone (
p
= 0.020) levels increased significantly; serum prolactin (
p
= 0.016) decreased significantly; while serum thyroid-stimulating hormone, follicle-stimulating hormone, and testosterone levels remained unchanged (all
p
> 0.05). Overall, there was no significant change in grade of HA dysfunction (
p
> 0.05). Male sex (OR:5.630, 95%CI:1.648–19.232;
p
= 0.006), tumor volume (OR:3.511, 95%CI:1.308–9.423;
p
= 0.013) and tumor diameter (OR:9.489, 95%CI:2.916–30.878;
p
< 0.0001) were significantly associated with postoperative HA dysfunction. Tumor volume and diameter (cut-off: 8.87 cm
3
and 2.95 cm, respectively) predicted postoperative HA dysfunction with a sensitivity of 96.0% and 92.0%, and a specificity of 88.0% and 76.0%, respectively. New-onset diabetes insipidus (30%) was the predominant complication. Tumor diameter and volume are significant predictors of postoperative HA dysfunction. More than one third of patients improved their HA function, while it worsened in less than a third of patients.</description><identifier>ISSN: 1437-2320</identifier><identifier>EISSN: 1437-2320</identifier><identifier>DOI: 10.1007/s10143-024-03150-0</identifier><identifier>PMID: 39725802</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adrenocorticotropic Hormone - blood ; Adult ; Aged ; Female ; Humans ; Luteinizing Hormone - blood ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Neuroendocrine Tumors - pathology ; Neuroendocrine Tumors - surgery ; Neurosurgery ; Neurosurgical Procedures - methods ; Pituitary Neoplasms - pathology ; Pituitary Neoplasms - surgery ; Postoperative Complications - epidemiology ; Prospective Studies ; Treatment Outcome</subject><ispartof>Neurosurgical review, 2024-12, Vol.48 (1), p.4, Article 4</ispartof><rights>The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2024 Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c228t-7afd2e10b234332a4b116ffa2c9f7f08c0b4943400b191d8cfcf7711a55f865b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10143-024-03150-0$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10143-024-03150-0$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39725802$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Singh, Harsimran</creatorcontrib><creatorcontrib>Sharma, Achal</creatorcontrib><creatorcontrib>Choudhary, Madhur</creatorcontrib><creatorcontrib>Jain, Gaurav</creatorcontrib><creatorcontrib>Sharma, Vinod</creatorcontrib><title>Factors affecting hormonal outcomes in patients undergoing surgery for non-functioning pituitary neuroendocrine tumors: a prospective observational study</title><title>Neurosurgical review</title><addtitle>Neurosurg Rev</addtitle><addtitle>Neurosurg Rev</addtitle><description>Surgical resection of non-functioning pituitary neuroendocrine tumors (NF-PitNET) is associated with new onset hormonal axis (HA) dysfunction, and factors predicting HA dysfunction are controversial, especially in large and giant NF-PitNET. Thus, we evaluated the postoperative hormonal function and assessed factors affecting HA dysfunction in patients with NF-PitNET. This prospective observational study involved 50 patients who underwent endoscopic surgical resection of NF-PitNET in the Department of Neurosurgery (April 2023–March 2024). The preoperative tumor diameter and volume were calculated radiologically. Hormonal evaluation was performed preoperatively, and again postoperatively at 7-days and 90-days. At 90-days, 36% patients recovered HA function, 34% remained unchanged, while 30% worsened. Serum cortisol (
p
< 0.0001), adrenocorticotropic hormone (
p
= 0.012), growth hormone (
p
= 0.013), and luteinizing hormone (
p
= 0.020) levels increased significantly; serum prolactin (
p
= 0.016) decreased significantly; while serum thyroid-stimulating hormone, follicle-stimulating hormone, and testosterone levels remained unchanged (all
p
> 0.05). Overall, there was no significant change in grade of HA dysfunction (
p
> 0.05). Male sex (OR:5.630, 95%CI:1.648–19.232;
p
= 0.006), tumor volume (OR:3.511, 95%CI:1.308–9.423;
p
= 0.013) and tumor diameter (OR:9.489, 95%CI:2.916–30.878;
p
< 0.0001) were significantly associated with postoperative HA dysfunction. Tumor volume and diameter (cut-off: 8.87 cm
3
and 2.95 cm, respectively) predicted postoperative HA dysfunction with a sensitivity of 96.0% and 92.0%, and a specificity of 88.0% and 76.0%, respectively. New-onset diabetes insipidus (30%) was the predominant complication. Tumor diameter and volume are significant predictors of postoperative HA dysfunction. More than one third of patients improved their HA function, while it worsened in less than a third of patients.</description><subject>Adrenocorticotropic Hormone - blood</subject><subject>Adult</subject><subject>Aged</subject><subject>Female</subject><subject>Humans</subject><subject>Luteinizing Hormone - blood</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Neuroendocrine Tumors - pathology</subject><subject>Neuroendocrine Tumors - surgery</subject><subject>Neurosurgery</subject><subject>Neurosurgical Procedures - methods</subject><subject>Pituitary Neoplasms - pathology</subject><subject>Pituitary Neoplasms - surgery</subject><subject>Postoperative Complications - epidemiology</subject><subject>Prospective Studies</subject><subject>Treatment Outcome</subject><issn>1437-2320</issn><issn>1437-2320</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9UU1v1TAQtBAVLa_9AxyQj1wC6480CbeqooBUiQs9W46zfqR6sYPXrtSfwr_F4RXUExfb2pmdWe8w9kbAewHQfSABQqsGpG5AiRYaeMHOaqVrpJLw8tn7lL0mugcQ3QDiFTtVQyfbHuQZ-3VjXY6JuPUeXZ7Dnv-IaYnBHngs2cUFic-BrzbPGDLxEiZM-7gRqaQ9pkfuY-IhhsaXUBVi2LB1zmXOtqIBS4oYpujSHJDnslS7j9zyNUVaN88H5HEkTA92667GlMv0eM5OvD0QXjzdO3Z38-n79Zfm9tvnr9dXt42Tss9NZ_0kUcAolVZKWj0Kcem9lW7wnYfewagHrTTAKAYx9c4733VC2Lb1_WU7qh17d9St8_wsSNksMzk8HGzAWMgooYdWS9XqSpVHqqujU0Jv1jQv9ZNGgNkiMcdITI3E_Imknjv29km_jAtO_1r-ZlAJ6kigCoW6UXMfS6p7oP_J_gZyNZwE</recordid><startdate>20241227</startdate><enddate>20241227</enddate><creator>Singh, Harsimran</creator><creator>Sharma, Achal</creator><creator>Choudhary, Madhur</creator><creator>Jain, Gaurav</creator><creator>Sharma, Vinod</creator><general>Springer Berlin Heidelberg</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20241227</creationdate><title>Factors affecting hormonal outcomes in patients undergoing surgery for non-functioning pituitary neuroendocrine tumors: a prospective observational study</title><author>Singh, Harsimran ; Sharma, Achal ; Choudhary, Madhur ; Jain, Gaurav ; Sharma, Vinod</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c228t-7afd2e10b234332a4b116ffa2c9f7f08c0b4943400b191d8cfcf7711a55f865b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Adrenocorticotropic Hormone - blood</topic><topic>Adult</topic><topic>Aged</topic><topic>Female</topic><topic>Humans</topic><topic>Luteinizing Hormone - blood</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Neuroendocrine Tumors - pathology</topic><topic>Neuroendocrine Tumors - surgery</topic><topic>Neurosurgery</topic><topic>Neurosurgical Procedures - methods</topic><topic>Pituitary Neoplasms - pathology</topic><topic>Pituitary Neoplasms - surgery</topic><topic>Postoperative Complications - epidemiology</topic><topic>Prospective Studies</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Singh, Harsimran</creatorcontrib><creatorcontrib>Sharma, Achal</creatorcontrib><creatorcontrib>Choudhary, Madhur</creatorcontrib><creatorcontrib>Jain, Gaurav</creatorcontrib><creatorcontrib>Sharma, Vinod</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Neurosurgical review</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Singh, Harsimran</au><au>Sharma, Achal</au><au>Choudhary, Madhur</au><au>Jain, Gaurav</au><au>Sharma, Vinod</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Factors affecting hormonal outcomes in patients undergoing surgery for non-functioning pituitary neuroendocrine tumors: a prospective observational study</atitle><jtitle>Neurosurgical review</jtitle><stitle>Neurosurg Rev</stitle><addtitle>Neurosurg Rev</addtitle><date>2024-12-27</date><risdate>2024</risdate><volume>48</volume><issue>1</issue><spage>4</spage><pages>4-</pages><artnum>4</artnum><issn>1437-2320</issn><eissn>1437-2320</eissn><abstract>Surgical resection of non-functioning pituitary neuroendocrine tumors (NF-PitNET) is associated with new onset hormonal axis (HA) dysfunction, and factors predicting HA dysfunction are controversial, especially in large and giant NF-PitNET. Thus, we evaluated the postoperative hormonal function and assessed factors affecting HA dysfunction in patients with NF-PitNET. This prospective observational study involved 50 patients who underwent endoscopic surgical resection of NF-PitNET in the Department of Neurosurgery (April 2023–March 2024). The preoperative tumor diameter and volume were calculated radiologically. Hormonal evaluation was performed preoperatively, and again postoperatively at 7-days and 90-days. At 90-days, 36% patients recovered HA function, 34% remained unchanged, while 30% worsened. Serum cortisol (
p
< 0.0001), adrenocorticotropic hormone (
p
= 0.012), growth hormone (
p
= 0.013), and luteinizing hormone (
p
= 0.020) levels increased significantly; serum prolactin (
p
= 0.016) decreased significantly; while serum thyroid-stimulating hormone, follicle-stimulating hormone, and testosterone levels remained unchanged (all
p
> 0.05). Overall, there was no significant change in grade of HA dysfunction (
p
> 0.05). Male sex (OR:5.630, 95%CI:1.648–19.232;
p
= 0.006), tumor volume (OR:3.511, 95%CI:1.308–9.423;
p
= 0.013) and tumor diameter (OR:9.489, 95%CI:2.916–30.878;
p
< 0.0001) were significantly associated with postoperative HA dysfunction. Tumor volume and diameter (cut-off: 8.87 cm
3
and 2.95 cm, respectively) predicted postoperative HA dysfunction with a sensitivity of 96.0% and 92.0%, and a specificity of 88.0% and 76.0%, respectively. New-onset diabetes insipidus (30%) was the predominant complication. Tumor diameter and volume are significant predictors of postoperative HA dysfunction. More than one third of patients improved their HA function, while it worsened in less than a third of patients.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>39725802</pmid><doi>10.1007/s10143-024-03150-0</doi></addata></record> |
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| subjects | Adrenocorticotropic Hormone - blood Adult Aged Female Humans Luteinizing Hormone - blood Male Medicine Medicine & Public Health Middle Aged Neuroendocrine Tumors - pathology Neuroendocrine Tumors - surgery Neurosurgery Neurosurgical Procedures - methods Pituitary Neoplasms - pathology Pituitary Neoplasms - surgery Postoperative Complications - epidemiology Prospective Studies Treatment Outcome |
| title | Factors affecting hormonal outcomes in patients undergoing surgery for non-functioning pituitary neuroendocrine tumors: a prospective observational study |
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