Sellar and perisellar meningiomas: effects on pituitary function in a Spanish cohort observational study

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发表日期：

2024年12月28日

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Fernando Guerrero-Pérez,
Betina Biagetti,
Miguel Paja-Fano,
Edelmiro Luis Menéndez-Torre,
Gonzalo Rivero,
Elena Dios,
Felicia Alexandra Hanzu,
Patricia Martín Rojas-Marcos,
Ana Irigaray,
María Dolores Moure Rodríguez,
Rogelio García-Centeno,
Laura González Fernández,
Joaquim Enseñat,
Mireia Mora,
Rocío Villar-Taibo,
Isabel M. Ortiz García,
Marta Araujo-Castro,
Carmen Gándara,
M Dolores Ollero García,
Carmen Tenorio-Jiménez,
Cristina Novo-Rodríguez,
Soralla Civantos,
Andreu Simó-Servat,
Anna Aulinas,
Queralt Asla,
Fernando Cordido,
Iría Novoa-Testa,
Gemma Xifra,
María Ayala-Conte,
Álvaro Zamarrón,
M Isabel García Berrocal,
Pedro Iglesias

摘要

Purpose

Studies focused on the effects of sellar and/or perisellar (S/PS) meningiomas on pituitary function are scarce. The primary objective of the present study was to determinate the effects that S/PS meningiomas and their treatments have on pituitary function. Also, we described the clinical characteristics and therapeutic outcomes of the cohort of adult Spanish patients.

Methods

A multicenter and retrospective study of patients with S/PS meningiomas attended in 20 tertiary Spanish centers.

Results

165 patients, 123 (74.5%) females, with median age of 61.4 [51–71] years were analyzed. At presentation, 115 (69.7%) had visual disturbance, 62 (37.6%) headache, 46 (27.9%) cranial nerve palsy and 34 (26.2%) hypopituitarism. Median tumor diameter was 29.1 [22–35.5] mm and cavernous sinus infiltration was detected in 95 (59%). As initial treatment, 128 (77.6%) underwent surgery, 25 (15.2%) received radiotherapy and 12 (7.3%) were clinically and radiologically monitored. Among operated patients, gross total resection (GTR) was achieved in 44 (34.4%), whereas in 84 (65.6%) the tumor was incompletely removed. Overall median follow-up was 5.7 [2.9–9.2] years. After treatments, hypopituitarism was present in 86 (53.4%) patients at the last evaluation, and it was associated with surgery extension (subtotal or GTR) but not with tumor subtype, type of radiotherapy or radiation dose received.

Conclusions

S/PS meningiomas affect the pituitary function in 25% of the cases. However, after the implementation of treatments, hypopituitarism prevails in more than 50% of the cases. They are relatively large tumors and GTR is achieved in one third of the cases in whom hypopituitarism is more prevalent.