Validation and Limitations of the PANOMEN-3 Predictive Model for Tumor Recurrence and Progression in Pituitary Tumors.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
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Araujo-Castro Marta, Menéndez Torre Edelmiro, Lozano-Aida Claudia, García-Centeno Rogelio, González Fernández Laura, Idrobo Cindy, Achote-Rea Estefanía, Irigaray Echarri Ana, Rodríguez-Argulló María Dolores Moure, Paja Miguel, Guerrero-Pérez Fernando, Castaño Justo P, Dolores Ollero García María, Novo-Rodríguez Cristina, Tenorio-Jimenéz Carmen, Villar-Taibo Rocío, Bernabeu Ignacio, Díaz-López Everardo, Calatayud María, Alvarez-Escola Cristina, Martín Rojas-Marcos Patricia, Recio-Córdova José María, Aulinas Anna, Asla Roca Queralt, Aviles María Dolores, López Mezquita Elena, Fernández-Argüeso María, González Molero Inmaculada, Ruz-Caracuel Ignacio, Aldecoa Iban, García Julia, Martínez-Sáez Elena, Hanzu Felicia, Marazuela Mónica, Puig-Domingo Manel, Biagetti Betina
Аннотация
OBJECTIVE: The aim of our study was to validate the classification proposed by the PANOMEN-3 group for the prediction of tumor recurrence/progression in PTs.
METHODS: Multicenter national case-control study of patients with PTs followed for at least 5 years. Kaplan-Meier curves were used to assess the time to tumor recurrence/progression. Univariate and multivariate Cox regression analyses were used to estimate the hazard ratio (HR) and prognostic capacity of the classification proposed by the PANOMEN-3 group.
RESULTS: A total of 1143 patients were included. Pituitary surgery was performed in 814 patients and the remaining 329 patients were followed with active surveillance or medical treatment. After a median follow-up of 8.8 years (5-29.8), 253 patients experienced tumor recurrence or biochemical/radiological progression and were classified as cases. The other 890 patients were classified as controls. The mean follow-up from PT diagnosis to recurrence was 7.2 ± 5.4 years. The diagnostic accuracy of the PANOMEN-3 model to predict recurrence/progression was 75.6% (95% CI 0.716-0.796). Residual tumor (HR 2.20, P < .001), a hereditary syndrome (HR 5.15, P = .026), and active secretory status (HR 1.80, P = .021) were the most important variables in this model. Recurrence/progression rate increased with increasing PANOMEN-3 grade (2.5% in grade 0; 10.3% in grade 1, 33.7% in grade 2, and 33.3% in grade 3; P < .001).
CONCLUSION: The predictive model proposed by the PANOMEN-3 group may be useful to guide the prognosis and therapy of PTs in the Spanish population since it offers a good accuracy to predict tumoral/biochemical recurrence and/or progression in operated and nonoperated patients.