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Introduction <p>Pituitary adenomas (PAs) are generally benign neoplasms, though in rare cases may exhibit aggressive behavior. In 2024, the PANOMEN-3 workshop released a new clinical-pathological classification. The objective of this study was to examine the potential of the PANOMEN-3 classification to predict prognosis of PAs and guide treatment in our single center cohort of patients with PAs.</p> Patients and methods <p>A longitudinal, retrospective, observational study was performed on patients with a PA diagnosis. The PANOMEN 3 classification was applied to each patient 6&#xa0;months after surgery. Resultant grades were correlated with surgical outcome, disease recurrence or progression.</p> Results <p>289 patients were included. According to the PANOMEN-3 classification, 9 patients (3.1%) were designated as grade 0, 101 patients as grade 1 (34.9%), 140 patients as grade 2 (48.4%) and 39 patients as a grade 3 (13.5%). At last follow-up assessment, 186 patients were found to be disease-free (64.4%), 93 patients (32.5%) exhibited a stable residual, 9 patients (3.1%) had recurrence and/or progression of their PA. The risk of recurrent/residual disease was increased in grade 1 (OR: OR:1.4 95%IC: 1.2–1.7), grade 2 (OR:1.5 95%IC: 1.2–1.9) and grade 3 (OR:5.7 95%IC: 2.7–12.5). Grades 1, 2 and 3 were associated with a shorter disease-free survival interval as compared to those with a grade 0 PANOMEN-3 score.</p> Conclusion <p>The PANOMEN-3 score is useful in clinical practice, aiding physicians to better plan patient follow-up, as well as to manage residual disease and treatment strategies post-surgery.</p>

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The clinicopathological PANOMEN-3 classification predicts pituitary adenoma prognosis: a real-world retrospective single center study of a surgically treated cohort

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  • 出版模式：

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  • 发表日期：

    2025年9月7日

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  • Sabrina Chiloiro,
  • Antonella Giampietro,
  • Raffaele Migliore,
  • Chiara Palumbo,
  • Penelope Giambò,
  • Flavia Costanza,
  • Pier Paolo Mattogno,
  • Rosalinda Calandrelli,
  • Tommaso Tartaglione,
  • Liverana Lauretti,
  • Mario Rigante,
  • Marco Gessi,
  • Simona Gaudino,
  • Laura De Marinis,
  • Antonio Bianchi,
  • Francesco Doglietto,
  • Alfredo Pontecorvi

摘要

Introduction

Pituitary adenomas (PAs) are generally benign neoplasms, though in rare cases may exhibit aggressive behavior. In 2024, the PANOMEN-3 workshop released a new clinical-pathological classification. The objective of this study was to examine the potential of the PANOMEN-3 classification to predict prognosis of PAs and guide treatment in our single center cohort of patients with PAs.

Patients and methods

A longitudinal, retrospective, observational study was performed on patients with a PA diagnosis. The PANOMEN 3 classification was applied to each patient 6 months after surgery. Resultant grades were correlated with surgical outcome, disease recurrence or progression.

Results

289 patients were included. According to the PANOMEN-3 classification, 9 patients (3.1%) were designated as grade 0, 101 patients as grade 1 (34.9%), 140 patients as grade 2 (48.4%) and 39 patients as a grade 3 (13.5%). At last follow-up assessment, 186 patients were found to be disease-free (64.4%), 93 patients (32.5%) exhibited a stable residual, 9 patients (3.1%) had recurrence and/or progression of their PA. The risk of recurrent/residual disease was increased in grade 1 (OR: OR:1.4 95%IC: 1.2–1.7), grade 2 (OR:1.5 95%IC: 1.2–1.9) and grade 3 (OR:5.7 95%IC: 2.7–12.5). Grades 1, 2 and 3 were associated with a shorter disease-free survival interval as compared to those with a grade 0 PANOMEN-3 score.

Conclusion

The PANOMEN-3 score is useful in clinical practice, aiding physicians to better plan patient follow-up, as well as to manage residual disease and treatment strategies post-surgery.