Abstract 739: Increased mortality in patients with pituitary adenomas

Abstract

Abstract Purpose: To evaluate mortality rate and causes of death in patients with pituitary adenomas. Material & Methods: Five hundred seventy-two patients with pituitary adenomas were identified in the Regional Cancer Registry in Umeå in northern Sweden between 1958 and 2007. Four hundred eighty-nine patients with a follow-up time ≤ 12 months from diagnosis of pituitary adenoma were included. Patients were followed until time of death, or the end of year 2007 through connection with the Swedish Population Register. During follow-up 228 patients (47 %) died. The primary causes of death were identified from the Swedish National Board of Health and Welfare's Cause of Death Register. The person-years at risk were calculated from the time of diagnosis of the pituitary adenoma until time of death. Standard mortality ratios (SMR) between observed and expected causes of death were calculated. Results: Two hundred twenty-eight patients (138 men, 90 women) died during follow-up. The expected number of deaths were 103, SMR = 2.22 (CI 1.94-2.52). Increased mortality was seen both in men, SMR = 1.98 (CI 1.66-2.34) and women, SMR = 2.71 (CI 2.18-3.33). The median age of death was 77 years (range, 14-94). The median follow-up was 13 years (range, 1-47), giving a total of 3 439 person-years. One hundred forty-eight patients had non-secreting adenomas, 41 patients had hormonally secreting adenomas and in 39 patients the type of adenoma was unknown. One hundred sixty-eight patients had their pituitary adenoma surgically resected, 158 patients received radiotherapy to the pituitary and 2 patients received neither surgery or radiotherapy. In 28 patients the treatment was unknown. One hundred twenty-two patients died in disorders of the circulatory system. The expected number of patients was 54, SMR = 2.26 (CI 1.88-2.70). Sixteen patients died in disorders of the respiratory system, 7 expected, SMR = 2.20 (CI 1.26-3.57). Seven patients died in disorders of the nervous system, 1 expected, SMR = 4.85 (CI 1.94-10.00). Six patients died in infectious diseases, 1 expected, SMR = 6.98 (CI 2.55-15.20). No increased mortality rate was seen in 28 patients who died from malignant tumours. The expected number was 24, SMR = 1.17 (CI 0.78-1.70). An increased mortality rate in cerebrovascular disorders was seen in both men and women who received radiotherapy to the pituitary. Twenty-nine patients (15 men and 14 women) who received radiotherapy died of cerebrovascular disorders. The expected number of patients was 6, SMR = 4,56 (CI 3.05-6.55). In patients who did not receive radiotherapy, the cerebrovascular mortality did not differ from the general population. Conclusions: Patients with pituitary adenomas had a two-fold increased mortality rate, compared to the general population. Patients who received radiotherapy to the pituitary had an increased mortality rate in cerebrovascular disorders compared to the general population and compared to patients who did not receive radiotherapy. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 739. doi:1538-7445.AM2012-739