Surgical management of pituitary adenomas: does age matter?

Tardivo, Valentina; Penner, Federica; Garbossa, Diego; Perna, Giuseppe Di; Pacca, Paolo; Salvati, Luca Francesco; Altieri, Roberto; Grottoli, Silvia; Zenga, Francesco

doi:10.1007/s11102-019-01014-1

Cited by 19 publications

(15 citation statements)

References 36 publications

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“…We also found that treatment modalities varied by age group and patients aged > 74 years may not receive any treatment. Since older patients are more vulnerable to surgery-related complications such as hypopituitarism, cerebrospinal fluid leaks, and diabetes insipidus 29 , 30 , it is understandable that a wait-and-see protocol was more preferable in some cases. Moreover, the first peak of incidence rate in females coincided with the non-treatment group, a possible explanation being that the SEER database does not include data on conventional drug treatment, which would lead to a higher untreated rate.…”

Section: Discussionmentioning

confidence: 99%

Incidence, demographics, and survival of patients with primary pituitary tumors: a SEER database study in 2004–2016

Chen

Lyu

et al. 2021

Sci Rep

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Comprehensive investigations on the incidence and prognosis of pituitary tumors are still lacking. The present study aims to summarize the incidence, demographics, and survival outcome of pituitary adenoma on a population-based level. This study includes all pituitary adenomas reported in the Surveillance, Epidemiology, and End Results (SEER) database from 2004 to 2016 in the United States. Extensive clinical and demographic characteristics were extracted and submitted to group comparisons. The standardized incidence rate was calculated and stratified by year at diagnosis, age/sex and age/treatment groups. The Kaplan–Meier analysis and multivariable regressions were performed to identify the factors associated with overall survival. A total of 47,180 pituitary tumors were identified, including 47,030 typical adenomas, 111 uncertain behavior pituitary adenomas, and 39 pituitary carcinomas. The overall standardized incidence rate was 4.8 cases per 100,000 person-years and the annual incidence rate continually trended upwards, with a peak seen in 2015. We noticed a bimodal age-related distribution in females and a unimodal distribution in males. In the multivariate regression analysis, the factors associated with prolonged survival included typical adenoma, younger age, and smaller tumor size. Whereas, black and male patients had worse overall survival. Our study provides a reliable estimate on the incidence of pituitary adenoma and confirms that the annual standardized incidence rate is increasing. Pituitary adenomas have a satisfactory long-term prognosis and age, tumor size, and tumor subtypes are related to overall survival. Though statistically significant, our inferential findings should be constrained within the limitations of SEER database.

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Section: Discussionmentioning

confidence: 99%

Incidence, demographics, and survival of patients with primary pituitary tumors: a SEER database study in 2004–2016

Chen

Lyu

et al. 2021

Sci Rep

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“…37,38 Satisfactory treatment results in the elderly patients undergoing intracranial procedures have also been observed after surgery for benign tumors, such as pituitary adenomas and vestibular schwannomas. [39][40][41][42] found similar rates of complications and similar rates of facial nerve outcome and hearing preservation in the groups of elderly and younger patients, concluding that age alone may not be a contraindication for vestibular schwannoma surgery. However, Sylvester et al 43 in their study based on the national inpatient sample arrived at an opposite conclusion as they found higher in-hospital overall complication and mortality rates in older patients operated on for vestibular schwannomas, while emphasizing that although mortality was higher in the elderly, deaths were actually rare.…”

Section: Discussionmentioning

confidence: 82%

Surgical Management of Intracranial Meningiomas in the Elderly: Early and Long-term Outcomes

Czernicki¹

2020

CIA

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“…Rates of tumor resection also have approximated those of traditional microscopic approaches. However, the impact of ETS on outcomes specifically in the elderly, defined as 65 years of age, have only been evaluated in a small number of studies [5][6][7][8][9][10][11][12][13][14][15]. Moreover, these studies have had variability in selected patients and reported outcomes.…”

Section: Accepted Manuscriptmentioning

confidence: 99%

“…Surgical outcomes after ETS for PAs have generally been good [16][17][18]. Several studies have aimed to evaluate the impact of ETS resection of PAs in the elderly specifically [5][6][7][8][9][10][11][12][13][14][15] (Table 5).…”

Section: Surgical Outcomes For Ets In the Elderlymentioning

confidence: 99%

Surgical Outcomes of Endoscopic Transsphenoidal Pituitary Adenoma Resection in Elderly Versus Younger Patients

Alexander

Chitguppi

Collopy

et al. 2021

J Neurol Surg B Skull Base

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Introduction Pituitary adenomas (PAs) are one of the most common type of intracranial neoplasm with increased incidence in elderly patients. The outcomes of endoscopic transsphenoidal surgery (ETS) specifically on elderly patients remains unclear. Methods We performed a retrospective cohort study to compare elderly patients (age 65 years) with non-elderly patients (age <65 years) who underwent ETS for PA from January 2005 to December 2021. Surgical outcomes, including extent of resection, complication profile, length of stay, and endocrinopathy rates, were compared between elderly and non-elderly patients. Results A total of 690 patients were included with 197 (29%) being elderly. Elderly patients showed higher rates of hypertension (p<0.05), myocardial infarction (p<0.01), and atrial fibrillation (p=0.01) but not other comorbidities. Elderly patients also had more frequent optic nerve involvement (72% of cases vs. 61%, p=0.01). Tumor characteristics and other patient variables were otherwise similar between younger and elderly patients. Postoperative CSF leaks (2% vs. 2%, p=0.8), 30-day readmission, reoperation, postoperative complications, and postoperative endocrinopathies were similar between younger and older patients. Subdividing patients into age <65, 65-79, and >80 also did not demonstrate a worsening of surgical outcomes with age. Conclusion For well selected elderly patients in experienced endoscopic skull base centers, good surgical outcomes similarly to younger patients may be achieved.

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Surgical management of pituitary adenomas: does age matter?

Cited by 19 publications

References 36 publications

Incidence, demographics, and survival of patients with primary pituitary tumors: a SEER database study in 2004–2016

Incidence, demographics, and survival of patients with primary pituitary tumors: a SEER database study in 2004–2016

Surgical Management of Intracranial Meningiomas in the Elderly: Early and Long-term Outcomes

Surgical Outcomes of Endoscopic Transsphenoidal Pituitary Adenoma Resection in Elderly Versus Younger Patients

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