Dugoročno praćenje bolesnika s nefunkcionalnim tumorima hipofize

master's thesis

• Title (english): Long term follow-up of patients with non-functional pituitary tumors
• Author: Roman Brekalo
• Mentor: Ivana Kraljević (mentor)
• Committee member: Tomislav Bulum (predsjednik povjerenstva)
• Committee member: Ivana Vuković Brinar (član povjerenstva)
• Committee member: Ivana Kraljević (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; Zagreb
• Defense date and country: 2024-07-12, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine

Abstract

Cilj ovog rada bio je procijeniti dugoročne ishode rezidua adenoma hipofize te vjerojatnost pojave recidiva nakon potpune resekcije. Ovim retrospektivnim kohortnim istraživanjem analizirani su pacijenti koju su podvrgnuti operaciji zbog nefunkcionalnog adenoma hipofize (NFPA) u razdoblju od 2005. do 2018. godine na Klinici za unutarnje bolesti KBC-a Zagreb. Dinamika rasta rezidua tumora ili pojava recidiva pratila se postoperativno putem MR-snimki te podataka prikupljenih iz medicinske dokumentacije pacijenata. U istraživanje je bilo uključeno 130 pacijenata, od kojih je većina bila muškog spola (N=85, 65,4%). Medijan dobi pacijenata bio je 57 (18 – 78) godina. Prosječno vrijeme praćenja pacijenata bilo je 90,5 (36 – 223) mjeseci. Postoperativno je uočena rezidua kod 65,4% pacijenata, a od 45 pacijenata kod kojih je postignuta potpuna resekcija, njih 10 (22,2%) razvilo je recidiv NFPA tijekom postoperativnog praćenja. Analizirajući skupine pacijenata s progresivnim i sta- bilnim reziduama NFPA uočena je statistički značajna razlika u dobi pacijenata i vrijednosti Ki- 67. Međutim, nije bilo statistički značajne razlike u veličini tumora ili invaziji kavernoznog sinusa između ovih skupina. Kod pacijenata kod kojih je zabilježena pojava recidiva NFPA nakon pot- pune resekcije nije bilo značajnih razlika u dobi, spolu i invaziji kavernoznog sinusa u odnosu na skupinu bez recidiva, međutim ova skupina imala je znatno duže vrijeme praćenja (p=0,05) Zaključno, zbog manjka jasnih prediktivnih čimbenika za porast rezidua ili pojavu recidiva potrebno je dugoročno pratiti pacijente redovnim MR-snimkama kako bi se na vrijeme uočila potreba za novom terapijskom intervencijom te smanjila mogućnost potencijalnih komplikacija rasta tumora.

Abstract (english)

The aim of this study was to assess the long-term outcomes of pituitary adenoma residue and the probability of recurrence after complete resection. This retrospective cohort study analyzed patients who underwent surgery due to non-functional pituitary adenoma (NFPA) between 2005 and 2018 at the Clinic for Internal Medicine of the University Hospital Center Zagreb. The dynamics of tumor residue growth or recurrence were monitored postoperatively through MRI scans and data collected from patients' medical records. The study included 130 patients, the majority of whom were male (N=85, 65,4%). The median age of the patients was 57 (range 18 – 78). The average follow-up time for patients was 90.5 months (range 36 – 223). Postoperative residue was observed in 65.4% of patients, and among 45 patients who had complete resection of the tumor, 10 (22,2%) of them had a tumor recurrence during post- operative follow-up. Analyzing groups of patients with progressive and stable NFPA residues, a statistically significant difference was observed in the age of patients and Ki-67 values. However, there was no statistically significant difference in tumor size or invasion of the cavernous sinus between these groups. In patients with complete resection of NFPA, recurrence was recorded in 22.2% of patients, but there were no significant differences in age, gender, or invasion of the cav- ernous sinus compared to the group without recurrence. However, this group had a significantly longer follow-up time (p=0,05). In conclusion, due to the lack of clear predictive factors for residue growth or recurrence, it is necessary to monitor patients long-term with regular MRI scans to timely detect the need for new therapeutic interventions and reduce the possibility of potential tumor growth complications.

• Keywords: nefunkcionalni tumori hipofize; operacija; rezidue adenoma; recidivi
• Keywords (english): non-functional pituitary tumors; surgery; residual adenoma; recurrence
• Language: croatian
• URN:NBN: urn:nbn:hr:105:541297
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2024-06-25 13:24:07