Reclassification of a cohort of patients with pituitary neuroendocrine tumors: importance in the prediction of recurrence and/or tumor progression
Pituitary neuroendocrine tumors (PitNETs) represent 15% of intracranial tumors. The early recognition of tumors that will have an aggressive behavior, is one of the therapeutic challenges to decide which group of patients need more intensive treatment. According to this, Trouillas et al. propos...
| Autores principales: | , , , , |
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| Formato: | Artículo revista |
| Lenguaje: | Español |
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Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología
2023
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| Materias: | |
| Acceso en línea: | https://revistas.unc.edu.ar/index.php/med/article/view/42717 |
| Aporte de: |
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I10-R327-article-42717 |
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Universidad Nacional de Córdoba |
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Revista de la Facultad de Ciencias Médicas de Córdoba |
| language |
Español |
| format |
Artículo revista |
| topic |
neuroendocrinology pituitary gland PitNETs clinical-pathological-prognostic classification neuroendocrinología Hipófisis PitNETs clasificación clínico-patológica-pronóstica |
| spellingShingle |
neuroendocrinology pituitary gland PitNETs clinical-pathological-prognostic classification neuroendocrinología Hipófisis PitNETs clasificación clínico-patológica-pronóstica Mondino, F Bertolino, ML Laborié, MV Mukdsi, JH Cecenarro, LA Reclassification of a cohort of patients with pituitary neuroendocrine tumors: importance in the prediction of recurrence and/or tumor progression |
| topic_facet |
neuroendocrinology pituitary gland PitNETs clinical-pathological-prognostic classification neuroendocrinología Hipófisis PitNETs clasificación clínico-patológica-pronóstica |
| author |
Mondino, F Bertolino, ML Laborié, MV Mukdsi, JH Cecenarro, LA |
| author_facet |
Mondino, F Bertolino, ML Laborié, MV Mukdsi, JH Cecenarro, LA |
| author_sort |
Mondino, F |
| title |
Reclassification of a cohort of patients with pituitary neuroendocrine tumors: importance in the prediction of recurrence and/or tumor progression |
| title_short |
Reclassification of a cohort of patients with pituitary neuroendocrine tumors: importance in the prediction of recurrence and/or tumor progression |
| title_full |
Reclassification of a cohort of patients with pituitary neuroendocrine tumors: importance in the prediction of recurrence and/or tumor progression |
| title_fullStr |
Reclassification of a cohort of patients with pituitary neuroendocrine tumors: importance in the prediction of recurrence and/or tumor progression |
| title_full_unstemmed |
Reclassification of a cohort of patients with pituitary neuroendocrine tumors: importance in the prediction of recurrence and/or tumor progression |
| title_sort |
reclassification of a cohort of patients with pituitary neuroendocrine tumors: importance in the prediction of recurrence and/or tumor progression |
| description |
Pituitary neuroendocrine tumors (PitNETs) represent 15% of intracranial tumors. The early recognition of tumors that will have an aggressive behavior, is one of the therapeutic challenges to decide which group of patients need more intensive treatment. According to this, Trouillas et al. proposed a "clinical-pathological-prognostic" classification, which integrates radiological, clinical, and immunocytological data and delineates 5 groups of tumors: "1a" (non-invasive/non-proliferative), "1b" (non-invasive/proliferative), "2a" (invasive/non-proliferative), "2b" (invasive/proliferative) and "3" (carcinoma), demonstrating utility to evaluate the prognosis of patients with aggressive tumors and predicting the risk of recurrence of PitNETs. General Aim: To determine the usefulness of the clinical-pathological-prognostic classification, to predict prognosis, in a cohort of patients with PitNETs.
An observational, analytical, retrospective and longitudinal study. 52 patients who underwent surgery between 2015-2020 were included. Pre/postoperative pituitary resonance, Ki-67 value, mitotic index, p53 expression and postoperative evolution were analyzed. Corresponding statistical tests were used. p<0.05 was considered significant.
53.8% of the patients were women and the mean age was 50 years. A total of 26 patients obtained enough data to be able to re-classify them. The 65.4% correspond to grade "2a", 19.2% to grade "2b", and 15.4% to grade "1a". There were no patients in grades "1b" or "3". Regarding the evolution, 73% showed "Persistence" of the disease, of which 79% correspond to grade 2a and 21% to grade 2b. The rest of the patients demonstrated "Complete Remission" of the disease, with the same distribution (50%) for grades 1a and 2a.
Our results showed the usefulness of the clinical-pathological-prognostic classification to identify a more aggressive subgroup of PitNETs (grade 2b) with a higher risk of progression/ recurrence after initial surgery, because all of them evidenced "persistence" of disease, and it could be beneficial in clinical practice to optimize patient follow-up, preventing complications in this risk population.
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| publisher |
Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología |
| publishDate |
2023 |
| url |
https://revistas.unc.edu.ar/index.php/med/article/view/42717 |
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I10-R327-article-427172023-10-19T21:19:40Z Reclassification of a cohort of patients with pituitary neuroendocrine tumors: importance in the prediction of recurrence and/or tumor progression Reclasificación de una cohorte de pacientes con tumores neuroendocrinos hipofisarios: importancia en la predicción de recurrencia y/o progresión tumoral Mondino, F Bertolino, ML Laborié, MV Mukdsi, JH Cecenarro, LA neuroendocrinology pituitary gland PitNETs clinical-pathological-prognostic classification neuroendocrinología Hipófisis PitNETs clasificación clínico-patológica-pronóstica Pituitary neuroendocrine tumors (PitNETs) represent 15% of intracranial tumors. The early recognition of tumors that will have an aggressive behavior, is one of the therapeutic challenges to decide which group of patients need more intensive treatment. According to this, Trouillas et al. proposed a "clinical-pathological-prognostic" classification, which integrates radiological, clinical, and immunocytological data and delineates 5 groups of tumors: "1a" (non-invasive/non-proliferative), "1b" (non-invasive/proliferative), "2a" (invasive/non-proliferative), "2b" (invasive/proliferative) and "3" (carcinoma), demonstrating utility to evaluate the prognosis of patients with aggressive tumors and predicting the risk of recurrence of PitNETs. General Aim: To determine the usefulness of the clinical-pathological-prognostic classification, to predict prognosis, in a cohort of patients with PitNETs. An observational, analytical, retrospective and longitudinal study. 52 patients who underwent surgery between 2015-2020 were included. Pre/postoperative pituitary resonance, Ki-67 value, mitotic index, p53 expression and postoperative evolution were analyzed. Corresponding statistical tests were used. p<0.05 was considered significant. 53.8% of the patients were women and the mean age was 50 years. A total of 26 patients obtained enough data to be able to re-classify them. The 65.4% correspond to grade "2a", 19.2% to grade "2b", and 15.4% to grade "1a". There were no patients in grades "1b" or "3". Regarding the evolution, 73% showed "Persistence" of the disease, of which 79% correspond to grade 2a and 21% to grade 2b. The rest of the patients demonstrated "Complete Remission" of the disease, with the same distribution (50%) for grades 1a and 2a. Our results showed the usefulness of the clinical-pathological-prognostic classification to identify a more aggressive subgroup of PitNETs (grade 2b) with a higher risk of progression/ recurrence after initial surgery, because all of them evidenced "persistence" of disease, and it could be beneficial in clinical practice to optimize patient follow-up, preventing complications in this risk population. Los tumores neuroendocrinos hipofisarios (PitNETs) representan el 15% de los tumores intracraneales. Una de las principales preocupaciones terapéuticas, es el reconocimiento temprano de los que se comportarán agresivamente, ya que requieren tratamiento más intensivo. Por ello, Trouillas y colaboradores, propusieron una clasificación “clínica-patológica-pronóstica”, donde se integran datos radiológicos, clínicos, e inmunocitológicos y delinea 5 grupos de tumores: "1a" (no invasivo/no proliferativo), "1b" (no invasivo/proliferativo), "2a" (invasivo/no proliferativo), "2b" (invasivo/proliferativo) y "3" (carcinoma), demostrando ser útil al evaluar el pronóstico de los pacientes con tumores agresivos y en la predicción del riesgo de recurrencia de los PitNETs. Objetivo General: Determinar la utilidad de la clasificación clínico-patológica-pronóstica, para predecir el pronóstico, en una cohorte de pacientes con PitNETs. Se llevó a cabo un estudio observacional, analítico, retrospectivo y longitudinal. Se incluyeron 52 pacientes operados entre 2015-2020. Se analizaron: resonancia hipofisaria pre/postoperatoria, valor de Ki-67, índice mitótico, p53 y la evolución postoperatoria. Se utilizó test Chi cuadrado y exacto de Fisher. Para la correlación: Coeficiente de Pearson y/o Regresión Logística. Se consideró significativo p< 0.05. El 53.8% de los pacientes son mujeres y la media de edad es de 50 años. Del total de los pacientes, 26 obtuvieron datos suficientes para poder re-clasificarlos. De ellos el 65,4% corresponden al grado “2a”, 19,2% al grado “2b”, y 15,4% al grado “1a”. No hubo pacientes en grados “1b”, ni “3”. En cuanto a la evolución, el 73% mostró “Persistencia” de la enfermedad, de ellos 79% corresponden al grado 2a y 21% al grado 2b. El resto de los pacientes mostraron “Remisión Completa” de la enfermedad, con igual distribución (50%) para los grados 1a y 2a. Nuestros hallazgos evidenciaron la utilidad de la clasificación para identificar un subgrupo de PitNETs más agresivos (grado 2b) con un riesgo mayor de progresión o recurrencia después de la cirugía inicial, ya que todos ellos evidenciaron “persistencia” de enfermedad luego del tratamiento quirúrgico. La aplicación de esta herramienta beneficiosa en la práctica clínica, podría optimizar el seguimiento y prevenir las complicaciones en esta población de riesgo. Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2023-10-19 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://revistas.unc.edu.ar/index.php/med/article/view/42717 Revista de la Facultad de Ciencias Médicas de Córdoba.; Vol. 80 (2023): Suplemento JIC XXIV Revista de la Facultad de Ciencias Médicas de Córdoba; Vol. 80 (2023): Suplemento JIC XXIV Revista da Faculdade de Ciências Médicas de Córdoba; v. 80 (2023): Suplemento JIC XXIV 1853-0605 0014-6722 spa https://revistas.unc.edu.ar/index.php/med/article/view/42717/42877 Derechos de autor 2023 Universidad Nacional de Córdoba http://creativecommons.org/licenses/by-nc/4.0 |