Evidence map›Paper›PMID 38995473›Full record

ArticlePituitary2024

Outcome of non-functioning ACTH pituitary tumors: silent does not mean indolent.

Nicolas Sahakian, Lise Goetz, Romain Appay, Thomas Graillon, Isabelle Raingeard, Cécilia Piazzola, Jean Regis, Frédéric Castinetti, Thierry Brue, Henry Dufour and 1 more

Abstract read
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In one paragraph

Article in Pituitary, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Nicolas Sahakian *Aix Marseille Univ, APHM, INSERM, MMG, Marmara Institute, La Conception University Hospital, Department of Endocrinology, CRMR HYPO, Marseille, France.
Lise Goetz *Department of Endocrinology, University Hospital of Montpellier, Montpellier, France.
Romain AppayDepartment of Pathological Anatomy and Neuropathology, Timone Hospital, APHM, Marseille, France.
Thomas GraillonAix Marseille Univ, APHM, INSERM, MMG, Marmara Institute, Timone Hospital, Department of Neurosurgery, CRMR HYPO, Marseille, France.
Isabelle RaingeardDepartment of Endocrinology, University Hospital of Montpellier, Montpellier, France.
Cécilia PiazzolaAix Marseille Univ, APHM, INSERM, MMG, Marmara Institute, La Conception University Hospital, Department of Endocrinology, CRMR HYPO, Marseille, France.
Jean RegisDepartment of Functional and Stereotactic Neurosurgery, CHU Timone, Aix Marseille University, INS-UMR1106, Marseille, 13385, France.
Frédéric CastinettiAix Marseille Univ, APHM, INSERM, MMG, Marmara Institute, La Conception University Hospital, Department of Endocrinology, CRMR HYPO, Marseille, France.
Thierry BrueAix Marseille Univ, APHM, INSERM, MMG, Marmara Institute, La Conception University Hospital, Department of Endocrinology, CRMR HYPO, Marseille, France.
Henry DufourAix Marseille Univ, APHM, INSERM, MMG, Marmara Institute, Timone Hospital, Department of Neurosurgery, CRMR HYPO, Marseille, France.
Thomas CunyAix Marseille Univ, APHM, INSERM, MMG, Marmara Institute, La Conception University Hospital, Department of Endocrinology, CRMR HYPO, Marseille, France. thomas.cuny@ap-hm.fr.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionSilent corticotroph tumors (siACTH) represent a rare entity of pituitary tumors (PT), usually more aggressive than other PT. Few predictor factors of recurrence in the post-operative period have been proposed until now. This study aimed (1) to evaluate the clinical outcome of siACTH after surgery according to a five-tiered clinicopathological classification (2) to compare siACTH characteristics to ACTH-secreting macroadenomas (macroCD), and silent gonadotropinomas (siLH/FSH). PATIENTS AND

methodsBetween 2008 and 2022, 29 siACTH out of 865 PT cases operated in one tertiary center were included. Clinical, paraclinical, histological, and surgical data were collected and compared to 25 macroCD and 143 siLH/FSH cases, respectively. The tumor grading was established according to both invasion (no = 1; yes = 2) and proliferation (no = a; yes = b). Progression-free survival was estimated using Kaplan-Meier method and log-rank test.

resultsWe identified 15 (51.7%) grade 1a, 11 (37.9%) grade 2a and 3 (10.3%) grade 2b siACTH with a trend for a 7-fold-time higher risk of progression/recurrence in grade 2b as compared to 1a (p = 0.06). The repartition of tumor grades was similar between the three subgroups, however a 5.7-fold-higher risk of progression was observed in grade 1a siACTH than in grade 1a siLH/FSH (p = 0.02). Compared to siLH/FSH, higher ACTH levels may help to preoperatively identify siACTH.

conclusionThe five-tiered clinicopathological classification contribute to predict the risk of recurrence of operated siACTH tumors. Noteworthy, non-invasive and non-proliferative siACTH exhibit a less favorable outcomes than their siLH/FSH counterparts, which should prompt for a personalized follow up.

Indexed as

Pituitary NeoplasmsACTH-Secreting Pituitary AdenomaAdrenocorticotropic HormoneAdultAgedFemaleHumansMaleMiddle AgedNeoplasm Recurrence, LocalAdrenocorticotropic HormoneKi-67Mitotic countp53Pituitary tumorSilent corticotropinoma

Identifiers

PMID38995473

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.