Natural History of Postoperative Nonfunctioning Pituitary Adenomas: A Systematic Review and Meta-Analysis
Natural History of Postoperative Nonfunctioning Pituitary Adenomas: A Systematic Review and Meta-Analysis
复制标题
DOI：
10.1159/000339823
复制
发表时间：
2012-01-01
影响因子：
4.1
通讯作者：
Wu, Zhe Bao
中科院分区：
文献类型：
--
作者：
Chen, Yong;Wang, Cheng De;Wu, Zhe Bao
目的：以往的研究试图确定术后无功能垂体腺瘤（pNFPA）的自然史，但由于选择偏倚和/或数量少和/或研究结果缺乏一致性而受到一定的限制。本研究的目的是仔细阅读文献，以分析pNFPAs的自然史。方法：计算机检索MEDLINE、PubMed、科克伦CENTRAL等数据库。收集与pNFPAs患者术后未接受放疗和药物治疗相关的文献。合格的研究报告了肿瘤复发率、5年和10年的无肿瘤生长生存率（TGFSR）和/或残留肿瘤体积倍增时间（TVDT）。结果：19项研究符合标准。pNFPAs分为两组：第I组（371例患者）的合并复发率为12%（95% CI 6-19%），5年和10年的TGFSR分别为96%（95% CI 89-99%）和82%（95% CI 65-94%）。第二组600例患者术后复发率为46%（95% CI 36-56%），术后5年和10年TGFSR分别为56%（95% CI 41-71%）和40%（95% CI 27-53%）。平均TVDT为3.4年（95% CI 2.4-4.5年）。结论：pNFPAs，有或没有可检测的残留肿瘤，需要分层的治疗和放射学/内分泌随访策略。根据TVDT，残余肿瘤再生长非常缓慢，这允许对大多数患者进行广泛和安全的随访计划。版权所有（C）2012 S. Karger AG，巴塞尔
Objective: Previous studies attempting to define the natural history of postoperative nonfunctioning pituitary adenomas (pNFPAs) were somewhat limited by selection bias and/or small numbers and/or lack of consistency among the study findings. The aim of this study was to scrutinize the literature in order to analyze the natural history of pNFPAs. Methods: Electronic database including MEDLINE, PubMed and Cochrane CENTRAL were searched. The literature relating to the patients with pNFPAs without postoperative radiotherapy and pharmacotherapy was collected. Eligible studies reported on the rate of tumor recurrence, the tumor growth-free survival rate (TGFSR) at 5 and 10 years, and/or the residual tumor volume doubling time (TVDT). Results: 19 studies met the criteria. The pNFPAs were divided into two groups: the pooled recurrence rate of group I without detectable residual tumor (371 patients) was 12% (95% CI 6-19%), the TGFSR at 5 and 10 years were 96% (95% CI 89-99%) and 82% (95% CI 65-94%), respectively. The pooled recurrence rate of group II with residual tumor (600 patients) was 46% (95% CI 36-56%), the TGFSR at 5 and 10 years were 56% (95% CI 41-71%) and 40% (95% CI 27-53%), respectively. The mean TVDT was 3.4 years (95% CI 2.4-4.5 years). Conclusions: pNFPAs, with or without detectable residual tumor, need stratification of treatment and radiological/endocrinological follow-up strategy. According to the TVDT, residual tumor regrowth is very slow, which permits an extensive and safe follow-up program for most patients. Copyright (C) 2012 S. Karger AG, Basel