GH replacement in patients with non‐functioning pituitary adenoma (NFA) treated solely by surgery is not associated with increased risk of tumour recurrence

Arnold, José; Arnold, Dana; Marland, Anne; Karavitaki, Niki; Wass, John

doi:10.1111/j.1365-2265.2008.03391.x

Cited by 46 publications

(30 citation statements)

References 22 publications

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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%

“…However, the results from intracranial tumors treated with GH indicated that GHRT was not associated with increased risk of recurrence/progression. During the period of GH treatment, the dose of GH was adjusted regularly depending on serum level of IGF-1 [5]. Thus, in patients treated with GH, the level of GH was elevated in accordance with the normal reference levels of IGF-1.…”

Section: Discussionmentioning

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%

“…Furthermore, in patients with prolonged critical illness, high doses of GH are associated with increased morbidity and mortality [4]. However, recent studies have demonstrated that long-term GH use in hypopituitarism may be considered safe in patients with central nervous system (CNS) tumors [5][6][7]. However, the role of GHRT toward the progression of CNS tumor in patients remained poorly understood.…”

Section: Introductionmentioning

confidence: 99%

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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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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Ghrt For Pituitary Adenomasmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

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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“…Secondary neoplasias were detected both before and after commencing GH replacement (67). Finally, in 130 patients with non-functioning pituitary adenoma treated with surgery alone, treatment with GH for a mean period of 6.8 years was not associated with increased recurrence of the pituitary tumour (68). Therefore, these relatively small studies do not suggest that GH replacement increases the recurrence or regrowth of hypothalamicpituitary tumours.…”

Section: Hypothalamic-pituitary Tumoursmentioning

confidence: 84%

Safety aspects of GH replacement

Svensson¹,

Bengtsson²

2009

European Journal of Endocrinology

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In adults, GH replacement therapy will often be maintained for decades. Owing to the long duration of GH replacement in many adults, it is essential to establish the long-term safety aspects of the treatment. In this review, studies that have investigated the safety profile of long-term GH replacement will be reviewed with an emphasis on studies based on data from the Pfizer International Metabolic Database (KIMS). These studies show that long-term GH replacement in adults is safe and that long-term GH replacement may even improve cardiovascular mortality and morbidity in GH-deficient adults.

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Adult Growth Hormone Deficiency

Vaughan

Riley

Blevins

2013

Pituitary Disorders

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GH replacement in patients with non‐functioning pituitary adenoma (NFA) treated solely by surgery is not associated with increased risk of tumour recurrence

Abstract: GH replacement in patients with NFA treated by surgery alone is not associated with an increased risk of tumour recurrence.

Cited by 46 publications

References 22 publications

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

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

Safety aspects of GH replacement

Adult Growth Hormone Deficiency

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