Pituitary · 2025
The clinicopathological PANOMEN-3 classification predicts pituitary adenoma prognosis: a real-world retrospective single center study of a surgically treated cohort.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Chiloiro Sabrina, Giampietro Antonella, Migliore Raffaele, Palumbo Chiara, Giambò Penelope, Costanza Flavia, Mattogno Pier Paolo, Calandrelli Rosalinda, Tartaglione Tommaso, Lauretti Liverana, Rigante Mario, Gessi Marco, Gaudino Simona, De Marinis Laura, Bianchi Antonio, Doglietto Francesco, Pontecorvi Alfredo
Аннотация
INTRODUCTION: Pituitary adenomas (PAs) are generally benign neoplasms, though in rare cases may exhibit aggressive behavior. In 2024, the PANOMEN-3 workshop released a new clinical-pathological classification. The objective of this study was to examine the potential of the PANOMEN-3 classification to predict prognosis of PAs and guide treatment in our single center cohort of patients with PAs.
PATIENTS AND METHODS: A longitudinal, retrospective, observational study was performed on patients with a PA diagnosis. The PANOMEN 3 classification was applied to each patient 6 months after surgery. Resultant grades were correlated with surgical outcome, disease recurrence or progression.
RESULTS: 289 patients were included. According to the PANOMEN-3 classification, 9 patients (3.1%) were designated as grade 0, 101 patients as grade 1 (34.9%), 140 patients as grade 2 (48.4%) and 39 patients as a grade 3 (13.5%). At last follow-up assessment, 186 patients were found to be disease-free (64.4%), 93 patients (32.5%) exhibited a stable residual, 9 patients (3.1%) had recurrence and/or progression of their PA. The risk of recurrent/residual disease was increased in grade 1 (OR: OR:1.4 95%IC: 1.2-1.7), grade 2 (OR:1.5 95%IC: 1.2-1.9) and grade 3 (OR:5.7 95%IC: 2.7-12.5). Grades 1, 2 and 3 were associated with a shorter disease-free survival interval as compared to those with a grade 0 PANOMEN-3 score.
CONCLUSION: The PANOMEN-3 score is useful in clinical practice, aiding physicians to better plan patient follow-up, as well as to manage residual disease and treatment strategies post-surgery.
PATIENTS AND METHODS: A longitudinal, retrospective, observational study was performed on patients with a PA diagnosis. The PANOMEN 3 classification was applied to each patient 6 months after surgery. Resultant grades were correlated with surgical outcome, disease recurrence or progression.
RESULTS: 289 patients were included. According to the PANOMEN-3 classification, 9 patients (3.1%) were designated as grade 0, 101 patients as grade 1 (34.9%), 140 patients as grade 2 (48.4%) and 39 patients as a grade 3 (13.5%). At last follow-up assessment, 186 patients were found to be disease-free (64.4%), 93 patients (32.5%) exhibited a stable residual, 9 patients (3.1%) had recurrence and/or progression of their PA. The risk of recurrent/residual disease was increased in grade 1 (OR: OR:1.4 95%IC: 1.2-1.7), grade 2 (OR:1.5 95%IC: 1.2-1.9) and grade 3 (OR:5.7 95%IC: 2.7-12.5). Grades 1, 2 and 3 were associated with a shorter disease-free survival interval as compared to those with a grade 0 PANOMEN-3 score.
CONCLUSION: The PANOMEN-3 score is useful in clinical practice, aiding physicians to better plan patient follow-up, as well as to manage residual disease and treatment strategies post-surgery.