Purpose 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. Methods 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. Results 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). Conclusions 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.
机构:
Santiago de Compostela Univ, Div Endocrinol, Santiago De Compostela, SpainSantiago de Compostela Univ, Div Endocrinol, Santiago De Compostela, Spain
Casanueva, Felipe F.
Barkan, Ariel L.
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Univ Michigan Hlth Syst, Div Endocrinol, Ann Arbor, MI USASantiago de Compostela Univ, Div Endocrinol, Santiago De Compostela, Spain
Barkan, Ariel L.
Buchfelder, Michael
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机构:
Univ Hosp Erlangen, Dept Neurosurg, Erlangen, GermanySantiago de Compostela Univ, Div Endocrinol, Santiago De Compostela, Spain
Buchfelder, Michael
Klibanski, Anne
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机构:
Massachusetts Gen Hosp, Neuroendocrine Unit, Boston, MA 02114 USASantiago de Compostela Univ, Div Endocrinol, Santiago De Compostela, Spain
Klibanski, Anne
Laws, Edward R.
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机构:
Brigham & Womens Hosp, Dept Neurosurg, 75 Francis St, Boston, MA 02115 USASantiago de Compostela Univ, Div Endocrinol, Santiago De Compostela, Spain
Laws, Edward R.
Loeffler, Jay S.
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机构:
Massachusetts Gen Hosp, Dept Radiat Oncol, Boston, MA 02114 USASantiago de Compostela Univ, Div Endocrinol, Santiago De Compostela, Spain
Loeffler, Jay S.
Melmed, Shlomo
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机构:
Cedars Sinai Med Ctr, Los Angeles, CA 90048 USASantiago de Compostela Univ, Div Endocrinol, Santiago De Compostela, Spain
Melmed, Shlomo
Mortini, Pietro
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机构:
San Raffaele Univ, Dept Neurosurg, Hlth Inst, Milan, ItalySantiago de Compostela Univ, Div Endocrinol, Santiago De Compostela, Spain
Mortini, Pietro
Wass, John
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Churchill Hosp, Oxford Ctr Diabet Endocrinol & Metab, Oxford, EnglandSantiago de Compostela Univ, Div Endocrinol, Santiago De Compostela, Spain
Wass, John
Giustina, Andrea
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h-index: 0
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San Raffaele Univ Hosp, Div Endocrinol, Milan, ItalySantiago de Compostela Univ, Div Endocrinol, Santiago De Compostela, Spain
机构:
Hosp Civils Lyon, Federat Endocrinol, Grp Hosp Est, F-69372 Lyon, France
Univ Lyon, Ctr Rech Neurosci, CNRS UMR5292, INSERM U1028, F-69372 Lyon, FranceHop Bicetre, Serv Endocrinol & Malad Reprod, AP HP, F-94275 Le Kremlin Bicetre, France
Raverot, Gerald
Castinetti, Frederic
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机构:
Univ Aix Marseille, Assistance Publ Hop Marseille, Hop La Timone, Serv Endocrinol, Marseille, FranceHop Bicetre, Serv Endocrinol & Malad Reprod, AP HP, F-94275 Le Kremlin Bicetre, France
Castinetti, Frederic
Cortet-Rudelli, Christine
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机构:
CHU Lille, Serv Endocrinol Metabol, F-59000 Lille, FranceHop Bicetre, Serv Endocrinol & Malad Reprod, AP HP, F-94275 Le Kremlin Bicetre, France
Cortet-Rudelli, Christine
Galland, Francoise
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机构:
CHU Rennes, Serv Endocrinol Diabetol & Nutr, Hop Sud, F-35000 Rennes, FranceHop Bicetre, Serv Endocrinol & Malad Reprod, AP HP, F-94275 Le Kremlin Bicetre, France
Galland, Francoise
Salenave, Sylvie
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Hop Bicetre, Serv Endocrinol & Malad Reprod, AP HP, F-94275 Le Kremlin Bicetre, FranceHop Bicetre, Serv Endocrinol & Malad Reprod, AP HP, F-94275 Le Kremlin Bicetre, France
机构:
Santiago de Compostela Univ, Div Endocrinol, Santiago De Compostela, SpainSantiago de Compostela Univ, Div Endocrinol, Santiago De Compostela, Spain
Casanueva, Felipe F.
Barkan, Ariel L.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Michigan Hlth Syst, Div Endocrinol, Ann Arbor, MI USASantiago de Compostela Univ, Div Endocrinol, Santiago De Compostela, Spain
Barkan, Ariel L.
Buchfelder, Michael
论文数: 0引用数: 0
h-index: 0
机构:
Univ Hosp Erlangen, Dept Neurosurg, Erlangen, GermanySantiago de Compostela Univ, Div Endocrinol, Santiago De Compostela, Spain
Buchfelder, Michael
Klibanski, Anne
论文数: 0引用数: 0
h-index: 0
机构:
Massachusetts Gen Hosp, Neuroendocrine Unit, Boston, MA 02114 USASantiago de Compostela Univ, Div Endocrinol, Santiago De Compostela, Spain
Klibanski, Anne
Laws, Edward R.
论文数: 0引用数: 0
h-index: 0
机构:
Brigham & Womens Hosp, Dept Neurosurg, 75 Francis St, Boston, MA 02115 USASantiago de Compostela Univ, Div Endocrinol, Santiago De Compostela, Spain
Laws, Edward R.
Loeffler, Jay S.
论文数: 0引用数: 0
h-index: 0
机构:
Massachusetts Gen Hosp, Dept Radiat Oncol, Boston, MA 02114 USASantiago de Compostela Univ, Div Endocrinol, Santiago De Compostela, Spain
Loeffler, Jay S.
Melmed, Shlomo
论文数: 0引用数: 0
h-index: 0
机构:
Cedars Sinai Med Ctr, Los Angeles, CA 90048 USASantiago de Compostela Univ, Div Endocrinol, Santiago De Compostela, Spain
Melmed, Shlomo
Mortini, Pietro
论文数: 0引用数: 0
h-index: 0
机构:
San Raffaele Univ, Dept Neurosurg, Hlth Inst, Milan, ItalySantiago de Compostela Univ, Div Endocrinol, Santiago De Compostela, Spain
Mortini, Pietro
Wass, John
论文数: 0引用数: 0
h-index: 0
机构:
Churchill Hosp, Oxford Ctr Diabet Endocrinol & Metab, Oxford, EnglandSantiago de Compostela Univ, Div Endocrinol, Santiago De Compostela, Spain
Wass, John
Giustina, Andrea
论文数: 0引用数: 0
h-index: 0
机构:
San Raffaele Univ Hosp, Div Endocrinol, Milan, ItalySantiago de Compostela Univ, Div Endocrinol, Santiago De Compostela, Spain
机构:
Hosp Civils Lyon, Federat Endocrinol, Grp Hosp Est, F-69372 Lyon, France
Univ Lyon, Ctr Rech Neurosci, CNRS UMR5292, INSERM U1028, F-69372 Lyon, FranceHop Bicetre, Serv Endocrinol & Malad Reprod, AP HP, F-94275 Le Kremlin Bicetre, France
Raverot, Gerald
Castinetti, Frederic
论文数: 0引用数: 0
h-index: 0
机构:
Univ Aix Marseille, Assistance Publ Hop Marseille, Hop La Timone, Serv Endocrinol, Marseille, FranceHop Bicetre, Serv Endocrinol & Malad Reprod, AP HP, F-94275 Le Kremlin Bicetre, France
Castinetti, Frederic
Cortet-Rudelli, Christine
论文数: 0引用数: 0
h-index: 0
机构:
CHU Lille, Serv Endocrinol Metabol, F-59000 Lille, FranceHop Bicetre, Serv Endocrinol & Malad Reprod, AP HP, F-94275 Le Kremlin Bicetre, France
Cortet-Rudelli, Christine
Galland, Francoise
论文数: 0引用数: 0
h-index: 0
机构:
CHU Rennes, Serv Endocrinol Diabetol & Nutr, Hop Sud, F-35000 Rennes, FranceHop Bicetre, Serv Endocrinol & Malad Reprod, AP HP, F-94275 Le Kremlin Bicetre, France
Galland, Francoise
Salenave, Sylvie
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h-index: 0
机构:
Hop Bicetre, Serv Endocrinol & Malad Reprod, AP HP, F-94275 Le Kremlin Bicetre, FranceHop Bicetre, Serv Endocrinol & Malad Reprod, AP HP, F-94275 Le Kremlin Bicetre, France