Comparing progression of non-functioning pituitary adenomas in hypopituitarism patients with and without long-term GH replacement therapy

Olsson, Daniel S; Buchfelder, Michael; Schlaffer, Sven; Bengtsson, Bengt‐Åke; Jakobsson, Karl-Erik; Johannsson, Gudmundur; Nilsson, Anders

doi:10.1530/eje-09-0572

Cited by 51 publications

(30 citation statements)

References 46 publications

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“…This result is comparable with the results of studies in AGHD patients with underlying craniopharyngioma [34,35] and with underlying non-functioning pituitary adenoma [36,37], suggesting that Norditropin ® treatment does not increase the risk for the development of these diseases. In fact, a recently published statement asserts that available data do not indicate an increased risk of new primary cancers or recurrence of primary cancer in AGHD patients [38].…”

Section: Discussionsupporting

confidence: 83%

Safety and effectiveness of long-term growth hormone therapy in Japanese patients with adult growth hormone deficiency: a postmarketing, multicenter, observational study

Shimatsu

Ishii

Nishinaga³

et al. 2017

Endocr J

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Section: Discussionsupporting

confidence: 83%

Safety and effectiveness of long-term growth hormone therapy in Japanese patients with adult growth hormone deficiency: a postmarketing, multicenter, observational study

Shimatsu

Ishii

Nishinaga³

et al. 2017

Endocr J

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“…Additional characteristics of the included studies are shown in Table 1. As shown in table, seven of the selected studies obtained seven or more scores, which indicated that the study quality was relatively higher [5][6][7][14][15][16][17][18][19][20][21][22]; whereas, other studies with relatively lesser scores were considered of lower quality [23][24][25].…”

Section: Resultsmentioning

confidence: 99%

“…Four studies [5,19,20,22] assessed the relationship between GHRT and risk of recurrence/progression in pituitary adenomas. The cumulative estimated risk associated with GH use was 0.85 (95 % CI 0.65-1.11; I 2 = 16.6 %, p for heterogeneity = 0.309).…”

Section: Ghrt For Pituitary Adenomasmentioning

confidence: 99%

Growth hormone therapy and risk of recurrence/progression in intracranial tumors: a meta-analysis

Shen

Sun

et al. 2015

Neurol Sci

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Growth hormone deficiency is common in intracranial tumors, which is usually treated with surgery and radiotherapy. A number of previous studies have investigated the relationship between the growth hormone replacement therapy (GHRT) and risk of tumor recurrence/ progression; however, the evidence remains controversial. We conducted a meta-analysis of published studies to estimate the potential relation between GHRT and intracranial tumors recurrence/progression. Three comprehensive databases, PUBMED, EMBASE, and Cochrane Library, were researched with no limitations, covering all published studies till the end of July, 2014. Reference lists from identified studies were also screened for additional database. The summary relative risks (RR) and 95 % confidence intervals (CI) were calculated by fixed-effects models for estimation. Fifteen eligible studies, involving more than 2232 cases and 3606 controls, were included in our meta-analysis. The results indicated that intracranial tumors recurrence/progression was not associated with GHRT (RR 0.48, 95 % CI 0.39-0.56), and for children, the pooled RR was 0.44 and 95 % CI was 0.34-0.54. In subgroup analysis, risks of recurrence/progression were decreased for craniopharyngioma, medulloblastoma, astrocytoma, glioma, but not for pituitary adenomas, and non-functioning pituitary adenoma (NFPA), ependymoma.Results from our analysis indicate that GHRT decreases the risk of recurrence/progression in children with intracranial tumors, craniopharyngioma, medulloblastoma, astrocytoma, or glioma. However, GHRT for pituitary adenomas, NFPA, and ependymoma was not associated with the recurrence/progression of the tumors. GH replacement seems safe from the aspect of risk of tumor progression.

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“…Recent findings indicate that this is not the case in patients with NFPA (17,18). It is well known that CPs have a high tumour progression rate -in fact after 10 years of follow-up around half of all CP patients who have not received RT develop tumour progression (1).…”

Section: Introductionmentioning

confidence: 99%

Tumour recurrence and enlargement in patients with craniopharyngioma with and without GH replacement therapy during more than 10 years of follow-up

Olsson

Buchfelder

Wiendieck

et al. 2012

European Journal of Endocrinology

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Objective: Most patients who have been treated for craniopharyngioma (CP) are GH deficient (GHD). GH replacement therapy (GHRT) may stimulate tumour regrowth; and one of the concerns with long-term GHRT is the risk of tumour progression. Therefore, the objective was to study tumour progression in CP patients on long-term GHRT. Design: Case-control study. Patients and methods:The criteria for inclusion of cases were: i) GHD caused by CP; ii) GHRT O3 years; and iii) regular imaging. This resulted in 56 patients (mean age at diagnosis 25G16 years) with a mean duration of GHRT of 13.6G5.0 years. As controls, 70 CP patients who had not received GHRT were sampled with regard to follow-up, gender, age at diagnosis and initial radiation therapy (RT). Results: The 10-year tumour progression-free survival rate (PFSR) for the entire population was 72%. There was an association (hazard ratio, P value) between PFSR and initial RT (0.13, !0.001) and residual tumour (3.2, !0.001). The 10-year PFSR was 88% for the GHRT group and 57% for the control group. Substitution with GHRT resulted in the following associations to PFSR: GHRT (0.57, 0.17), initial RT (0.16, !0.001), residual tumour (2.6, !0.01) and gender (0.57, 0.10). Adjusted for these factors, the 10-year PFSR was 85% for the GHRT group and 65% for the control group. Conclusions: In patients with CP, the most important prognostic factors for the PFSR were initial RT and residual tumour after initial treatment. Long-term GHRT did not affect the PFSR in patients with CP.

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Comparing progression of non-functioning pituitary adenomas in hypopituitarism patients with and without long-term GH replacement therapy

Cited by 51 publications

References 46 publications

Safety and effectiveness of long-term growth hormone therapy in Japanese patients with adult growth hormone deficiency: a postmarketing, multicenter, observational study

Safety and effectiveness of long-term growth hormone therapy in Japanese patients with adult growth hormone deficiency: a postmarketing, multicenter, observational study

Growth hormone therapy and risk of recurrence/progression in intracranial tumors: a meta-analysis

Tumour recurrence and enlargement in patients with craniopharyngioma with and without GH replacement therapy during more than 10 years of follow-up

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