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- Title
Differences in invasiveness and recurrence rate among nonfunctioning pituitary neuroendocrine tumors depending on tumor subtype.
- Authors
Taguchi, Akira; Kinoshita, Yasuyuki; Amatya, Vishwa Jeet; Onishi, Shumpei; Go, Yukari; Tominaga, Atsushi; Takeshima, Yukio; Yamasaki, Fumiyuki; Horie, Nobutaka
- Abstract
Purpose: To clarify the invasiveness to surrounding structures and recurrence rate of each subtype of nonfunctioning pituitary neuroendocrine tumor (Pit-NETs) according to the WHO 2022 classification. Methods: This retrospective study utilized data from 292 patients with nonfunctioning Pit-NETs treated with initial transsphenoidal surgery. Recurrence was evaluated on 113 patients who were available for a magnetic resonance imaging follow-up ≥ 60 months. All tumors were assessed by immunohistochemical staining for Pit-1, T-PIT, and GATA3. Invasiveness to surrounding structures was evaluated based on intraoperative findings. Results: Cavernous sinus invasion was found in 47.5% of null cell tumors, 50.0% of Pit-1 lineage tumors, 31.8% of corticotroph tumors, and 18.3% of gonadotroph tumors. Dura mater defects in the floor of sellar turcica, indicating dural invasion, were found in 44.3% of null cell tumors, 36.4% of corticotroph tumors, 16.7% of Pit-1 lineage tumors, and 17.3% of gonadotroph tumors. In logistic regression analysis, Pit-1 (OR 5.90, 95% CI 1.71–20.4, P = 0.0050) and null tumors (OR 4.14, 95% CI 1.86–9.23, P = 0.0005) were associated with cavernous sinus invasion. Recurrence was found in 8 (4.9%) patients, but without significant differences between tumor subtypes. The presence of cavernous sinus invasion was correlated with recurrence (HR = 1.95, 95% CI 1.10–3.46, P = 0.0227). Conclusion: Among nonfunctioning Pit-NETs, Pit-1 lineage tumors tend to invade the cavernous sinus, corticotroph tumors may produce dura mater defects, and null cell tumors tend to cause both. Pit-NETs with cavernous sinus invasion require a careful attention to recurrence.
- Subjects
PITUITARY tumors; NEUROENDOCRINE tumors; CAVERNOUS sinus; DURA mater; CELL tumors; PITUITARY cancer
- Publication
Neurosurgical Review, 2023, p1
- ISSN
0344-5607
- Publication type
Article
- DOI
10.1007/s10143-023-02234-7