TY - JOUR
T1 - Optimal management of non-functioning pituitary adenomas
AU - Greenman, Yona
AU - Stern, Naftali
N1 - Publisher Copyright:
© 2015, Springer Science+Business Media New York.
PY - 2015/9/25
Y1 - 2015/9/25
N2 - Transsphenoidal surgery is the treatment of choice for large non-functioning pituitary adenomas (NFPA) and symptomatic patients. The therapeutic strategies for the management of NFPA after surgery, i.e., watchful waiting, irradiation, or medical therapy have not been compared by randomized controlled trials. Slow re-growth is common, but the natural history of untreated tumors is variable. Conservative follow-up is associated with progression rates of over 40 %. Radiation is highly effective in preventing residual tumor growth, but has serious long-term side effects. Finally, no medications are currently approved for the treatment of NFPA. In this review, we present our view of the optimal management of these tumors, which includes risk stratification for the identification of high-risk patients suitable for active intervention, leaving low-risk patients for careful monitoring.
AB - Transsphenoidal surgery is the treatment of choice for large non-functioning pituitary adenomas (NFPA) and symptomatic patients. The therapeutic strategies for the management of NFPA after surgery, i.e., watchful waiting, irradiation, or medical therapy have not been compared by randomized controlled trials. Slow re-growth is common, but the natural history of untreated tumors is variable. Conservative follow-up is associated with progression rates of over 40 %. Radiation is highly effective in preventing residual tumor growth, but has serious long-term side effects. Finally, no medications are currently approved for the treatment of NFPA. In this review, we present our view of the optimal management of these tumors, which includes risk stratification for the identification of high-risk patients suitable for active intervention, leaving low-risk patients for careful monitoring.
KW - Dopamine agonist
KW - Management
KW - Non-functioning
KW - Pituitary adenoma
KW - Radiation
KW - Surgery
UR - http://www.scopus.com/inward/record.url?scp=84940438371&partnerID=8YFLogxK
U2 - 10.1007/s12020-015-0685-8
DO - 10.1007/s12020-015-0685-8
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C2 - 26179179
AN - SCOPUS:84940438371
SN - 1355-008X
VL - 50
SP - 51
EP - 55
JO - Endocrine
JF - Endocrine
IS - 1
ER -