Tumor recurrence or regrowth in adults with nonfunctioning pituitary adenomas using GH replacement therapy

van Varsseveld, N. C.; van Bunderen, C. C.; Franken, A. A. M.; Koppeschaar, H. P. F.; van der Lely, A. J.; Drent, M. L.

doi:10.1210/jc.2015-1764

Cited by 26Pituitary Gland Disorders and TreatmentsGrowth Hormone and Insulin-like Growth FactorsNeuroendocrine Tumor Research Advances

Tumor recurrence or regrowth in adults with nonfunctioning pituitary adenomas using GH replacement therapy

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van Varsseveld, N. C., van Bunderen, C. C., Franken, A. A. M., Koppeschaar, H. P. F., van der Lely, A. J., Drent, M. L.·2015·The Journal of Clinical Endocrinology & Metabolism

DOI 10.1210/jc.2015-1764

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Abstract

CONTEXT: GH replacement therapy (GH-RT) is a widely accepted treatment in GH-deficient adults with nonfunctioning pituitary adenoma (NFPAs). However, some concerns have been raised about the safety of GH-RT because of its potentially stimulating effect on tumor growth. OBJECTIVE: The aim of this study was to evaluate tumor progression in NFPA patients using GH-RT. DESIGN, SETTING, AND PATIENTS: From the Dutch National Registry of Growth Hormone Treatment in Adults, a nationwide surveillance study in severely GH-deficient adults (1998-2009), all NFPA patients with ≥ 30 days of GH-RT were selected (n = 783). Data were retrospectively collected from the start of GH-RT in adulthood (baseline). MAIN OUTCOME MEASURE: Tumor progression, including tumor recurrence after complete remission at baseline and regrowth of residual tumor. RESULTS: Tumor progression developed in 12.1% of the patients after a median (range) time of 2.2 (0.1-14.9) years. Prior radiotherapy decreased tumor progression risk compared to no radiotherapy (hazard ratio = 0.16; 95% confidence interval, 0.09-0.26). Analysis in 577 patients with available baseline imaging data showed that residual tumor at baseline increased tumor progression risk compared to no residual tumor (hazard ratio = 4.5; 95% confidence interval, 2.4-8.2). CONCLUSIONS: The findings in this large study were in line with those reported in literature and provide further evidence that GH-RT does not appear to increase tumor progression risk in NFPA patients. Although only long-term randomized controlled trials will be able to draw firm conclusions, our data support the current view that GH-RT is safe in NFPA patients.

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Authors: van Varsseveld, N. C., van Bunderen, C. C., Franken, A. A. M., Koppeschaar, H. P. F., van der Lely, A. J., & Drent, M. L.
Affiliations: Amsterdam Neuroscience (NL)
ORCID: Franken, A. A. M.
Drent, M. L.
Venue: The Journal of Clinical Endocrinology & Metabolism
Publisher: The Endocrine Society
Published: 2015-08
Volume: 100
Issue: 8
Pages: 3132-3139
ISSN: 0021-972X (ISSN-L)
1945-7197
DOI: 10.1210/jc.2015-1764
OpenAlex: W1954717983
Semantic Scholar: de355240e5c28339c17f2f6c76aab58fe71c542c
Cited by: 26
References: 38
Citations by year: 2026: 2 · 2024: 2 · 2022: 4 · 2021: 2 · 2020: 3 · 2019: 3 · 2018: 4 · 2017: 3 · 2016: 3
FWCI: 2.89
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
PubMed (publishedVersion)
Pure Amsterdam UMC (publishedVersion, other-oa)
Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
EUR Research Repository (Erasmus University Rotterdam) (publishedVersion)
EUR Research Repository (Erasmus University Rotterdam) (submittedVersion)
Data Archiving and Networked Services (DANS) (submittedVersion)
Funders: Vrije Universiteit Amsterdam
Topics: Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Pituitary Gland Disorders and Treatments
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Growth Hormone and Insulin-like Growth Factors
Health Sciences › Medicine › Epidemiology › Neuroendocrine Tumor Research Advances
Keywords: non-functioning pituitary adenoma, growth hormone replacement therapy, tumor recurrence, tumor regrowth, residual tumor, growth hormone deficiency, radiotherapy, treatment safety, tumor progression risk
MeSH terms: Adenoma, Adult, Aged, Female, Humans, Hypopituitarism, Male, Middle Aged, Neoplasm Recurrence, Local, Netherlands, Pituitary Neoplasms, Retrospective Studies, Neoplasm, Residual, Disease Progression, Human Growth Hormone, Hormone Replacement Therapy, Cell Proliferation

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Tumor recurrence or regrowth in adults with nonfunctioning pituitary adenomas using GH replacement therapy

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