Transsphenoidal Surgery for Pituitary Neuroendocrine Tumours (PiTNETs) in a Tertiary Hospital: Are There Differences Between Young and Elderly Patients?

IF 3 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Clinical Endocrinology Pub Date : 2025-03-24 DOI:10.1111/cen.15242

Inés Borrego-Soriano, Paola Parra-Ramírez, Patricia Martín-Rojas-Marcos, Carlos Pérez-López, Pablo García-Feijoo, Cristina Álvarez-Escolá

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引用次数: 0

Abstract

Objective: The incidence of pituitary neuroendocrine tumours (PiTNET) in elderly patients is rising, but treatment recommendations and data of outcomes are limited. This study aimed to compare the clinical characteristics and surgical outcomes of elderly and younger patients.

Design: Retrospective and observational study.

Patients: One hundred twenty-four adults underwent transsphenoidal surgery due to PiTNET in our hospital from 2018 to 2023.

Measurements: We stratified the population according to age and compared the clinical features and surgical outcomes.

Results: Thirty-two patients (25.8%) were 65 years or older. Elderly patients had a lower rate of hormonal excess (15.6% vs. 60.9%, p < 0.001) and a higher rate of hypopituitarism (43.8% vs. 8.7%, p < 0.001), with a greater median number of affected axis (3 vs. 1, p < 0.001). Only the rate of ACTH excess was different between groups (0 vs. 26.1%, p = 0.003). The most common surgical indication in elderly patients was visual impairment (31.3%) compared to functionality in younger individuals (42.4%, p = 0.012). There were no differences in the Knosp grade, but elderly patients had a higher rate of macroadenomas (84.4% vs. 58.7%, p = 0.002). In the immediate postsurgical period, there were no differences in the rate of surgical or hormonal complications, or in the hospital stay. Ki67 was lower in elderly patients (1.44% vs. 2.77%, p = 0.045). After 6-12 months, there were no differences in the tumour resection rate, visual improvement, or hormonal status.

Conclusion: With experienced surgical and endocrinological care, transsphenoidal surgery for elderly patients with PiTNET is effective and safe.

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三级医院经蝶窦手术治疗垂体神经内分泌肿瘤（PiTNETs）：年轻和老年患者有差异吗？

目的：垂体神经内分泌肿瘤（PiTNET）在老年患者中的发病率正在上升，但治疗建议和结局数据有限。本研究旨在比较老年和年轻患者的临床特征和手术结果。设计：回顾性观察性研究。患者：2018年至2023年，我院124名成人因PiTNET接受了经蝶窦手术。测量：我们根据年龄对人群进行分层，并比较临床特征和手术结果。结果：65岁及以上患者32例（25.8%）。老年患者激素过量发生率较低（15.6% vs. 60.9%）。结论：在经验丰富的外科和内分泌护理下，经蝶窦手术治疗老年PiTNET患者是有效和安全的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Endocrinology 医学-内分泌学与代谢

CiteScore

6.40

自引率

3.10%

发文量

192

审稿时长

1 months

期刊介绍： Clinical Endocrinology publishes papers and reviews which focus on the clinical aspects of endocrinology, including the clinical application of molecular endocrinology. It does not publish papers relating directly to diabetes care and clinical management. It features reviews, original papers, commentaries, correspondence and Clinical Questions. Clinical Endocrinology is essential reading not only for those engaged in endocrinological research but also for those involved primarily in clinical practice.