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Although tumor growth and functional impairment are key considerations, the impact of patient sex on presentation and outcomes remains incompletely characterized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate clinical, radiological and histopathological predictors of long-term outcomes in NF-PitNETs managed conservatively or surgically and to evaluate gender impact on initial presentation and tumour natural history.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed 170 patients with NF-PitNETs, including those under active surveillance and those treated surgically, with or without adjuvant therapies. Long-term clinical, endocrine and radiological follow-up was performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Compared with female patients, males exhibited larger tumour dimensions and a higher prevalence of both visual field defects and endocrine dysfunction. Women, particularly in the surveillance cohort, had smaller tumours, often detected earlier, likely due to reproductive-age clinical monitoring. Despite these baseline differences, progression rates were similar between genders. In patients under surveillance, five-year tumour growth risk was higher for macroadenomas than microadenomas (45.7% vs. 22.5%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.030), and baseline tumour volume and visual impairment predicted progression. In the surgical cohort, residual tumour increased progression risk, while a\u2009&gt;\u200940% volume reduction was associated with visual improvement. The Trouillas clinicopathological classification was not predictive of outcomes. Adjuvant therapies, including stereotactic radiosurgery and temozolomide, stabilized disease in most treated cases.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Gender significantly influences NF-PitNETs presentation, with males harbouring larger, more symptomatic tumours whereas females tended to have an earlier detection. However, long-term progression seems to be independent of gender. These findings pinpoint the importance of individualized approach combining anatomical, volumetric, and functional assessments to optimize outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11102-026-01669-7","type":"journal-article","created":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T05:37:16Z","timestamp":1774589836000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Natural history of non-functioning pituitary neuroendocrine tumours: impact of baseline characteristics and gender-specific clinical presentations"],"prefix":"10.1007","volume":"29","author":[{"given":"Alessandro","family":"Bavaresco","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia","family":"Bovo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Mondin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carla","family":"Scaroni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giacomo","family":"Voltan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierluigi","family":"Mazzeo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene","family":"Tizianel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filippo","family":"Ceccato","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1081-5727","authenticated-orcid":false,"given":"Mattia","family":"Barbot","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,3,27]]},"reference":[{"issue":"3","key":"1669_CR1","doi-asserted-by":"publisher","first-page":"377","DOI":"10.1111\/j.1365-2265","volume":"72","author":"A Fernandez","year":"2010","unstructured":"Fernandez A, Karavitaki N, Wass JAH (2010) Prevalence of pituitary adenomas: a community-based, cross-sectional study in Banbury (Oxfordshire, UK). 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