ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Pituitary Endocrinology
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1653376
This article is part of the Research TopicSurgery and Management of Pituitary Region Tumours and Their Endocrine OutcomesView all 11 articles
Increased mortality in patients with Non-Functioning Pituitary Tumors: a study in a Tertiary Center
Provisionally accepted
Guadalupe Vargas-Ortega1
Edgar Manuel Ramírez-García1,2
Lourdes Balcázar Hernández1
Mario Enrique Rendon Macias3Carlos Alfonso Romero-Gameros4Baldomero González-Virla1*Blas López-Félix1Erick Zepeda1Eric Misael Estrada-Estrada1- 1Hospital de Especialidades Centro Medico Nacional Siglo XXI, Mexico City, Mexico
- 2Instituto Politecnico Nacional Escuela Superior de Medicina, Mexico City, Mexico
- 3Universidad Panamericana, Mexico City, Mexico
- 4Hospital Angeles Cuidad Juarez, Ciudad Juarez, Mexico
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Background information: Most of the studies on mortality, survival analysis and predictor variables in patients with non-functioning pituitary adenomas (NFPA) are heterogeneous and limited; and in some cases, they offer contradictory results. Patients and methods: Our objective was to analyze the survival of 749 patients (46.3% were women) with NFPA, with a mean follow-up of 60.2 months (32.9-120.6) at a tertiary center, from March 2007 to August 2023. Descriptive and inferential statistics were used. Mortality risk was determined in comparison with the Mexican population by calculating the standardized mortality ratio (SMR) with 99% confidence intervals. Survival analysis and Cox proportional hazards (HR) analysis were performed to identify possible predictors. Results: The overall SMR was of 8.86 (99% Confidence Interval [CI] 5.92-13.25, p<0.001), for <60 years-old patients, it was 13.77 (99% CI 7.23-26.23, p<0.001). In men, it was 7.08 (99% CI 3.92-12.80, p<0.001), and in women it was p<0.001). Regarding patients with arterial hypertension, we obtained 6.59 (99% CI 3.75-11.56, p<0.001), and with type 2 diabetes, it was 4.63 (99% CI 1.96-10.93, p<0.001). In the Cox analysis for mortality, an adjusted HR of 2.19 (95% CI 1.13-4.26, p=0.02) was observed for arterial hypertension and 1.32 (95% CI 1.00-1.75, p=0.04) for the total number of surgeries. The rest of the variables had no statistically significant association with mortality. Conclusion: Our study shows a higher mortality in patients diagnosed with NFPA compared to the general population. The higher probability of death was found in the presence of predictors such as arterial hypertension and the total number of surgeries.
Keywords: non-functioning pituitary adenomas, NFPA, Mortality, pituitary surgery, arterial hypertension, diabetes
Received: 24 Jun 2025; Accepted: 21 Jul 2025.
Copyright: © 2025 Vargas-Ortega, Ramírez-García, Balcázar Hernández, Rendon Macias, Romero-Gameros, González-Virla, López-Félix, Zepeda and Estrada-Estrada. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Baldomero González-Virla, Hospital de Especialidades Centro Medico Nacional Siglo XXI, Mexico City, Mexico
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