Adult; Cohort Studies; Female; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Multiple Endocrine Neoplasia Type 1/pathology; Pituitary Neoplasms/pathology; Retrospective Studies
Abstract :
[en] OBJECTIVE: Pituitary adenoma (PA) is one of the three major components of multiple endocrine neoplasia type 1 (MEN1). Recent studies have suggested that MEN1-associated PAs are less aggressive than initially estimated. We propose an analysis of the outcome of PAs with a standard of care treatment in a nationwide cohort of MEN1 patients. DESIGN: Retrospective observational nationwide cohort study using the MEN1 patient registry from the French Group of Endocrine Tumours (GTE). METHODS: The GTE database population consists of 1435 patients with MEN1. This analysis focused on 551 patients recruited after 2000 with at least 3 years of follow-up. The study outcome was tumour progression of PA defined by an increase in Hardy classification (HC) during follow-up according to referring physician regular reports. RESULTS: Among 551 MEN1 patients (index and related), 202 (36.7%) had PA, with 114 (56.4%) diagnosed by MEN1-related screening. PAs were defined according to HC as microadenoma (grade I) in 117 cases (57.9%), macroadenoma in 59 (29.2%) with 20 HC grade II and 39 HC grades III-IV and unspecified in 26 (12.8%). They were prolactinomas in 92 cases (45.5%) and non-secreting in 73 (36.1%). After a median follow-up of 3 years among the 137 patients with HC grades I-II, 4 patients (2.9%) presented tumour progression. CONCLUSION: PAs in patients with MEN1 are less aggressive than previously thought. Tumour progression is rare with a standard of care monitoring and treatment, especially in related patients who mostly present non-secreting microadenoma. MRI monitoring for asymptomatic MEN1 patients should be reduced accordingly.
Disciplines :
Endocrinology, metabolism & nutrition
Author, co-author :
Le Bras, Maelle ; CHU de Nantes PHU2 Institut du Thorax et du Système Nerveux, Service
Leclerc, Hélène; Centre Hospitalier de La Roche sur Yon, Department of Endocrinology and
Rousseau, Olivia; INSERM CIC 1413, Clinique des Données, CHU de Nantes, Nantes, France.
Goudet, Pierre; University Hospital Dijon, Endocrine Surgery, Hôpital du Bocage, Dijon, France.
Cuny, Thomas; Department of Endocrinology, Hopital de la Conception, Marseille, France.
Castinetti, Frederic ; Aix-Marseille Université, Assistance-Publique-Hôpitaux de Marseille, Centre de
Bauters, Catherine; CHU Lille, Service d'Endocrinologie, Lille, France.
Chanson, Philippe ; Assistance Publique-Hôpitaux de Paris, Endocrinology, Le Kremlin-Bicêtre
Tabarin, Antoine; Department of Endocrinology, Hôpital Haut Lévêque-CHU de Bordeaux, Pessac,
Gaujoux, Sebastien; Hopital Cochin, Digestive and Endocrine Surgery, Paris, France.
Christin-Maitre, Sophie; Hopital Saint-Antoine, Endocrine Unit, Paris, France.
Ruszniewski, Philippe; Department of Gastroenterology and Pancreatology, Université Paris Diderot,
Borson-Chazot, Francoise; Hospices Civils de Lyon, Fédération d'Endocrinologie Groupement Hospitalier Est,
Guilhem, Isabelle; Centre Hospitalier Universitaire de Rennes, Hôpital Sud, Service
Caron, Philippe; CHU Toulouse, Endocrinology and Metabolic diseases, Service d'Endocrinologie,
Goichot, Bernard; Hôpital de Hautepierre, Service de Medecine Interne et Nutrition, Strasbourg
Beckers, Albert ; Centre Hospitalier Universitaire de Liège - CHU > > Service d'endocrinologie clinique
Delemer, Brigitte; Hôpital Robert-Debré, CHU de Reims, Service Endocrinologie, Reims, France.
Raingeard, Isabelle; University Hospital of Montpellier, Endocrinology, Montpellier, France.
Vergès, Bruno; CHU Dijon, Hôpital du Bocage, Endocrinologie, Diabétologie, Dijon, France.
Smati, Sarra; CHU de Nantes PHU2 Institut du Thorax et du Système Nerveux, Service ; UNIV Nantes, CNRS, INSERM, CHU Nantes, l'Institut du Thorax, Nantes, France.
Wargny, Matthieu; CHU de Nantes PHU2 Institut du Thorax et du Système Nerveux, Service ; UNIV Nantes, CNRS, INSERM, CHU Nantes, l'Institut du Thorax, Nantes, France.
Cariou, Bertrand; CHU de Nantes PHU2 Institut du Thorax et du Système Nerveux, Service ; UNIV Nantes, CNRS, INSERM, CHU Nantes, l'Institut du Thorax, Nantes, France.
Hadjadj, Samy; CHU de Nantes PHU2 Institut du Thorax et du Système Nerveux, Service ; UNIV Nantes, CNRS, INSERM, CHU Nantes, l'Institut du Thorax, Nantes, France.
