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DOI: 10.1055/s-0039-1679705
A Population-Level Analysis of Pituitary Carcinoma from the National Cancer Database
Publication History
Publication Date:
06 February 2019 (online)
Objectives: Pituitary carcinoma is a rare entity with fewer than 200 total cases reported in the English literature. Analysis of the population-level data from the National Cancer Database (NCDB) affords the opportunity to study this poorly understood tumor type.
Methods: The NCDB was queried for site, histology, and metastasis codes corresponding to pituitary carcinoma. Statistical analyses were performed to determine factors associated with overall survival (OS).
Results: A total of 92 patients with pituitary carcinoma met inclusion criteria. The 1- and 5-year OS for all patients was 93.3% (95% CI [88.2–98.6%]) and 80.0% (95% CI [71.6–89.4%]). Patients with invasive primary tumor behavior had 1- and 5-year OS of 69.2% (95% CI [48.2–99.5%]) and 52.7% (95% CI [31.2–89.2%]). Multivariate analysis demonstrated that compared with benign primary behavior, invasive behavior had increased all-cause mortality (OR: 1,296, 95% CI [15.1–>2000]). Surgery without adjuvant radiation or chemotherapy was the most common therapy (48.9%), followed by no treatment (40.2%). Compared with surgery alone, no treatment had worse OS (OR: 11.83, 95% CI [1.41–99.56]). Increasing age and female sex were both associated with increased mortality.
Conclusion: The most common treatment for pituitary carcinoma is surgery alone which is associated with the highest overall survival. The efficacy of radiation, chemotherapy, and neurohormonal treatments needs to be examined with prospective studies.
