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This Article Full Text Full Text (PDF) All Versions of this Article: EJE-09-0572v1 161/5/663    most recent Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Olsson, D S Articles by Nilsson, A G PubMed PubMed Citation Articles by Olsson, D S Articles by Nilsson, A G

Comparing progression of non-functioning pituitary adenomas in hypopituitarism patients with and without long-term GH replacement therapy

Department of Endocrinology, Sahlgrenska University Hospital, SE-413 45 Gothenburg, Sweden¹ Department of Neurosurgery, University of Erlangen-Nuremberg, Erlangen, 951054 Germany² Department of Neurosurgery, Sahlgrenska University Hospital, SE-413 45 Gothenburg, Sweden

(Correspondence should be addressed to A G Nilsson; Email: anna.nilsson{at}medic.gu.se)

Objective: An important safety issue with GH replacement therapy (GHRT) in hypopituitary patients with a history of a pituitary adenoma is the risk for tumour recurrence or enlargement.

Design: Case–control study.

Subjects and methods: We studied tumour progression rate in 121 patients with hypopituitarism on the basis of non-functioning pituitary adenomas (NFPA) receiving long-term GHRT. A group of 114 NFPA patients not receiving GHRT who were matched in terms of duration of follow-up, gender, age, age at diagnosis and radiotherapy status were used as a control population. The average duration of GHRT was 10±4 years (range 2–17).

Results: In patients with a known residual adenoma, 63% had no detectable enlargement of tumour during the study. In patients who had no visible residual tumour prior to GHRT, 90% did not suffer from recurrence. In total, the 10-year tumour progression-free survival rate in patients with NFPA receiving GHRT was 74%. In the control population not receiving GHRT, the 10-year progression-free survival rate was 70%. Radiotherapy as part of the initial tumour treatment reduced the rate of tumour progression in both GHRT and non-GHRT patients to a similar extent.

Conclusions: The rate of tumour progression was similar in this large group of GHRT patients and the control population not receiving GHRT. Our results provide further support that long-term use of GH replacement in hypopituitarism may be considered safe in patients with residual pituitary adenomas.