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Growth Hormone Therapy Does Not Increase the Risk of Craniopharyngioma and Nonfunctioning Pituitary Adenoma Recurrence.
- Source :
-
The Journal of clinical endocrinology and metabolism [J Clin Endocrinol Metab] 2020 May 01; Vol. 105 (5). - Publication Year :
- 2020
-
Abstract
- Context: Recombinant human growth hormone (rhGH) replacement therapy is often prescribed in patients with nonfunctioning pituitary adenoma (NFPA) or craniopharyngioma.<br />Objective: To study whether rhGH therapy in patients with adult growth hormone deficiency (AGHD) increases the risk of pituitary tumor recurrence.<br />Design: Retrospective, observational study.<br />Setting: Tertiary care center.<br />Patients: We studied 283 consecutive patients with AGHD due to NFPA or craniopharyngioma between 1995 and 2018.<br />Intervention: rhGH treatment at standard doses was initiated in 123 patients (43.5%). The remaining 160 patients served as controls.<br />Main Outcome Measure: Risk of tumor recurrence in rhGH-treated and control patients.<br />Results: In univariate analysis, recurrence of the pituitary tumor was less frequent in rhGH-treated patients (19.5%) than in controls (29.7%; hazard ratio [HR] 0.53, 95% confidence interval [CI] 0.32-0.86; P = .01). Multivariate Cox analysis demonstrated that the risk of tumor recurrence was associated with detection of residual disease at the baseline magnetic resonance imaging (HR 9.17; 95% CI, 4.88-17.22; P < .001) and not having performed radiotherapy (HR 16.97; 95% CI, 7.55-38.16; P < .001), while rhGH treatment was no longer associated with a lower risk of recurrence (HR 0.82; 95% CI, 0.47-1.44; P = .50).<br />Conclusions: We found no association between rhGH replacement and the risk of tumor recurrence in patients with AGHD caused by NFPA or craniopharyngioma. These data add to the mounting evidence that rhGH therapy has a neutral effect on the recurrence of pituitary tumors.<br />Précis: Replacement therapy with rhGH is prescribed to patients with adult growth hormone deficiency. Our study found no increased risk of pituitary tumor recurrence.<br /> (© Endocrine Society 2020. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
- Subjects :
- Adenoma epidemiology
Adenoma surgery
Adult
Case-Control Studies
Craniopharyngioma epidemiology
Craniopharyngioma surgery
Female
Follow-Up Studies
Hormone Replacement Therapy adverse effects
Human Growth Hormone adverse effects
Humans
Hypophysectomy adverse effects
Hypopituitarism epidemiology
Hypopituitarism etiology
Male
Middle Aged
Neoplasm Recurrence, Local chemically induced
Neurosurgical Procedures adverse effects
Pituitary Neoplasms epidemiology
Pituitary Neoplasms surgery
Recombinant Proteins adverse effects
Recombinant Proteins therapeutic use
Retrospective Studies
Risk Factors
Adenoma pathology
Craniopharyngioma pathology
Human Growth Hormone therapeutic use
Hypopituitarism drug therapy
Neoplasm Recurrence, Local epidemiology
Pituitary Neoplasms pathology
Subjects
Details
- Language :
- English
- ISSN :
- 1945-7197
- Volume :
- 105
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- The Journal of clinical endocrinology and metabolism
- Publication Type :
- Academic Journal
- Accession number :
- 32112101
- Full Text :
- https://doi.org/10.1210/clinem/dgaa089