Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Validation of a Clinicopathological Classification for Predicting Outcomes of Pituitary Tumours: Retrospective Cohort Study in a Pituitary Tumour Centre of Excellence, 2013–2023

Version 1 : Received: 17 August 2023 / Approved: 18 August 2023 / Online: 21 August 2023 (09:59:52 CEST)

How to cite: Argüello Gordillo, T.; Castro-García, J. M.; Martínez Gauffin, L.; Kuptsov, A.; Moreno-Pérez, Ó.; Niveiro, M.; Abarca-Olivas, J.; Concepción-Aramendia, L.; Picó, A. Validation of a Clinicopathological Classification for Predicting Outcomes of Pituitary Tumours: Retrospective Cohort Study in a Pituitary Tumour Centre of Excellence, 2013–2023. Preprints 2023, 2023081412. https://doi.org/10.20944/preprints202308.1412.v1 Argüello Gordillo, T.; Castro-García, J. M.; Martínez Gauffin, L.; Kuptsov, A.; Moreno-Pérez, Ó.; Niveiro, M.; Abarca-Olivas, J.; Concepción-Aramendia, L.; Picó, A. Validation of a Clinicopathological Classification for Predicting Outcomes of Pituitary Tumours: Retrospective Cohort Study in a Pituitary Tumour Centre of Excellence, 2013–2023. Preprints 2023, 2023081412. https://doi.org/10.20944/preprints202308.1412.v1

Abstract

Immunostaining of transcription factors allows a more exact classification of pituitary neuroendocrine tumours (PitNETs), but not a better prediction of their clinical behaviour. This retrospective, single-centre study aims to classify a series of PitNETs using Trouillas et al.’s clinicopathological classification from 2013. We analysed 166 patients undergoing PitNET surgery in 2013–2023. Tumours were identified according to the gene and immunohistochemical expression of PitNET transcription factors plus adenohypophyseal hormones. Tumours were classified according to a grading system based on MRI invasion and Ki-67 index. Eighty-one (48.8%) patients had grade 2a tumours; 71 (42.8%), grade 1a; 8 (4.8%), 2b; and 6 (3.6%), 1b. At a mean follow-up of 57.8 (standard deviation 30) months, 13.9% (n=23) showed recurrence/progression; independent predictors of recurrence were tumour volume (p=0.031) and T2 signal intensity ratio (SIR) (p<0.001). This risk was 18.6-fold higher for a T2 SIR of 2 or more. Grade 2a and 2b tumours, T2 SIR, and silent corticotroph adenomas (SCAs) were associated with lower progression-free survival. Our results add more evidence to the prognostic value of the five-grade PitNET classification and suggest higher clinical surveillance of patients with SCAs is warranted. The MRI findings highlight the increasing value of radiological evaluation for managing PitNETs.

Keywords

Pituitary tumours; Pituitary neuroendocrine tumours; Pituitary adenomas; Clinicopathological classification; T2 signal intensity ratio values; Silent corticotroph tumour; Pituitary Transcription Factors

Subject

Medicine and Pharmacology, Endocrinology and Metabolism

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