A new prognostic clinicopathological classification of pituitary adenomas: a multicentric case-control study of 410 patients with 8 years post-operative follow-up. - Archive ouverte HAL Access content directly
Journal Articles Acta Neuropathologica Year : 2013

A new prognostic clinicopathological classification of pituitary adenomas: a multicentric case-control study of 410 patients with 8 years post-operative follow-up.

Nathalie Sturm
  • Function : Author
Emmanuelle Dantony
Christine Cortet-Rudelli
  • Function : Author
Jean-François Bonneville
  • Function : Author
Richard Assaker
  • Function : Author
Aurélie Cornelius
  • Function : Author
Henry Dufour
  • Function : Author
Emmanuel Jouanneau
  • Function : Author
Patrick François
  • Function : Author
Gérald Raverot
  • Function : Correspondent author
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Anne A. Barlier
M. Bernier
F. Borson-Chazot
  • Function : Author
O. Chabre
  • Function : Author
P. Chanson
J. F. Cottier
  • Function : Author
B. Delemer
  • Function : Author
E. Delgrange
  • Function : Author
L. Di Tommaso
  • Function : Author
S. Eimer
  • Function : Author
Sophie Gaillard
M. Jan
  • Function : Author
J. J. Girard
  • Function : Author
V. Lapras
  • Function : Author
H. Loiseau
  • Function : Author
J. G. Passagia
  • Function : Author
M. Patey
  • Function : Author
A. Penfornis
  • Function : Author
J. Y. Poirier
  • Function : Author
G. Perrin
A. Tabarin
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Abstract

Pituitary adenomas are currently classified by histological, immunocytochemical and numerous ultrastructural characteristics lacking unequivocal prognostic correlations. We investigated the prognostic value of a new clinicopathological classification with grades based on invasion and proliferation. This retrospective multicentric case-control study comprised 410 patients who had surgery for a pituitary tumour with long-term follow-up. Using pituitary magnetic resonance imaging for diagnosis of cavernous or sphenoid sinus invasion, immunocytochemistry, markers of the cell cycle (Ki-67, mitoses) and p53, tumours were classified according to size (micro, macro and giant), type (PRL, GH, FSH/LH, ACTH and TSH) and grade (grade 1a: non-invasive, 1b: non-invasive and proliferative, 2a: invasive, 2b: invasive and proliferative, and 3: metastatic). The association between patient status at 8-year follow-up and age, sex, and classification was evaluated by two multivariate analyses assessing disease- or recurrence/progression-free status. At 8 years after surgery, 195 patients were disease-free (controls) and 215 patients were not (cases). In 125 of the cases the tumours had recurred or progressed. Analyses of disease-free and recurrence/progression-free status revealed the significant prognostic value (p < 0.001; p < 0.05) of age, tumour type, and grade across all tumour types and for each tumour type. Invasive and proliferative tumours (grade 2b) had a poor prognosis with an increased probability of tumour persistence or progression of 25- or 12-fold, respectively, as compared to non-invasive tumours (grade 1a). This new, easy to use clinicopathological classification of pituitary endocrine tumours has demonstrated its prognostic worth by strongly predicting the probability of post-operative complete remission or tumour progression and so could help clinicians choose the best post-operative therapy.

Dates and versions

hal-00875723 , version 1 (22-10-2013)

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Jacqueline Trouillas, Pascal Roy, Nathalie Sturm, Emmanuelle Dantony, Christine Cortet-Rudelli, et al.. A new prognostic clinicopathological classification of pituitary adenomas: a multicentric case-control study of 410 patients with 8 years post-operative follow-up.. Acta Neuropathologica, 2013, 126 (1), pp.123-35. ⟨10.1007/s00401-013-1084-y⟩. ⟨hal-00875723⟩
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