Thyrotropin-secreting pituitary adenomas: a systematic review and meta-analysis of postoperative outcomes and management.

Détails

ID Serval
serval:BIB_231D826D7531
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Thyrotropin-secreting pituitary adenomas: a systematic review and meta-analysis of postoperative outcomes and management.
Périodique
Pituitary
Auteur(s)
Cossu G., Daniel R.T., Pierzchala K., Berhouma M., Pitteloud N., Lamine F., Colao A., Messerer M.
ISSN
1573-7403 (Electronic)
ISSN-L
1386-341X
Statut éditorial
Publié
Date de publication
02/2019
Peer-reviewed
Oui
Volume
22
Numéro
1
Pages
79-88
Langue
anglais
Notes
Publication types: Journal Article ; Review
Publication Status: ppublish
Résumé
TSH-secreting pituitary adenomas are rare pituitary tumors. An efficient treatment is essential to limit the mortality and morbidity in untreated patients. The aim of this study is to summarize the evidence about the postoperative outcomes and management of this rare pathology.
A systematic search and meta-analysis of surgical series was performed.
Our analysis included 23 articles (536 patients). No sex difference was observed and mean age at diagnosis was 45 years. Hyperthyroidism was reportedly clinical in 67% and biochemical in 90% of patients. Co-secretion of other pituitary hormones was present in 42% of cases. Macroadenomas were found in 79% of patients, showing in 44% and 30% of cases respectively extrasellar extension and cavernous sinus invasion. The pooled rate of postoperative biochemical remission was 69.7% and a gross total resection (GTR) was observed in 54% of patients. The extent of resection was significantly increased in microadenomas (p < 0.001) and cavernous sinus invasion was predictive of lower GTR rate (p < 0.001). A biochemical remission was achieved in 66% of patients after adjuvant radiation therapy and in 76% after adjuvant medical treatment. The combination of both allowed remission in 67% of cases. At final follow-up the overall biochemical remission rate was significantly improved (85.8%) when compared to the postoperative biochemical remission (p < 0.001).
When compared to the early postoperative period, at last follow-up biochemical remission was significantly greater (p < 0.001). GTR was achieved in half of patients; the size of tumor and cavernous sinus invasion determined the extent of resection.
Mots-clé
Adenoma/metabolism, Female, Humans, Male, Pituitary Neoplasms/metabolism, Postoperative Period, Thyrotropin/metabolism, Endoscopy, Pituitary adenoma, SITSH, TSH-secreting adenoma, Thyrotropin secreting adenoma, Transsphenoidal
Pubmed
Web of science
Création de la notice
16/11/2018 10:24
Dernière modification de la notice
26/03/2020 19:28
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