• Mortality

    Overall mortality is reported to be higher in pituitary adenoma patients in comparison with the normal population, primarily as a result of cardiovascular and cerebrovascular disease3.
    In a large cohort of mainly non-functioning pituitary adenomas of the Royal Marsden Hospital, the overall age adjusted relative risk (RR) of death was 1.76 in comparison with the normal population13. The few deaths from progressive pituitary ade-noma and from second brain tumours accounted for only a small excess mortality. An increased mortality was reported due to cerebrovascular accidents. In the pituitary ade-noma cohort of 334 patients, treated between 1962 and 1986, 128 deaths were observed versus 80.9 expected (RR of death: 1.58 (95% CI: 1.32 – 1.9). Of these 128 deaths, 33 (26%) were due to cerebrovascular deaths compared with 8.04 expected (RR 4.11: 95%CI: 2.84 – 5.75). Three of the 33 cerebrovascular deaths were due to subarachnoidal haemorrhage, compared to 0.54 expected deaths (RR 5.51: 95%CI: 1.14 -16.09). Any relationship with hypopituitarism, extent of surgery or radiation therapy could not be found.
    The Danish registry however reported no increased mortality due to cardiovascular and cerebrovascular disease. In this study, type of surgery and radiation therapy were not identified as risk factors, while female sex was a risk factor8. Moreover, no increased mortality due to malignant disease was reported in all kinds of pituitary adenoma8.
    Other groups however, report an increased mortality in incompletely controlled acromegaly patients in comparison with the general population due to cardiovascular and malignant disease14,15.
    Patients with untreated Cushing’s syndrome have excess mortality 16.

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