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Data at diagnosis and at 1- and 5-year follow-up, defined as assessments closest to 1 year (0.5\u2013&lt;2.5) and 5 years (2.5\u2013&lt;7.5), were retrieved. Surgery was recorded up to 7.5 years. Variables included adenoma size, pituitary function, visual impairment, and surgery. Patients were stratified into age groups 65\u201372, 73\u201380, and \u2265\u200981 years.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      At diagnosis, mean age was 76 years, females were older (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Mean adenoma diameter and volume were 20\u00a0mm and 3067\u00a0mm\u00b3. Visual field defects and reduced visual acuity were seen in 20% and 12%, with no sex differences. Males had more hormone deficiencies (45% vs. 33%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01). Hormone deficiencies and visual impairments increased with age (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). The oldest subgroup had the largest adenomas (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01), with females having larger tumours (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05) and males more deficiencies (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). Adenoma size, hormone deficiencies, and visual impairments remained stable over time within each age group. 6.7% underwent surgery during follow-up. In regression analyses, later surgery was associated with visual field defects at diagnosis (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05) but not with adenoma size.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Pituitary surgery was uncommon in conservatively managed elderly patients with macro-NFPAs. Baseline visual field defects, but not tumour size, were associated with subsequent surgery, supporting regular individualised follow-up in these patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11102-026-01752-z","type":"journal-article","created":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T13:03:09Z","timestamp":1787230989000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Natural history of conservatively managed nonfunctioning pituitary macroadenomas in the elderly: A study from the Swedish Pituitary Registry"],"prefix":"10.1007","volume":"29","author":[{"given":"Camilla","family":"Jerning","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte","family":"H\u00f6ybye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Bensing","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Britt Ed\u00e9n","family":"Engstr\u00f6m","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nasrin","family":"Al-Shamkhi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bertil","family":"Ekman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenza","family":"Bonelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henrik","family":"Borg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pia","family":"Burman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Per","family":"Dahlqvist","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor","family":"Hantelius","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oskar","family":"Ragnarsson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Svensson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeanette","family":"Wahlberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna-Karin","family":"\u00c5kerman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katarina","family":"Berinder","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2970-8593","authenticated-orcid":false,"given":"Maria","family":"Petersson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,8,20]]},"reference":[{"issue":"10","key":"1752_CR1","doi-asserted-by":"publisher","first-page":"R375","DOI":"10.1530\/ERC-20-0136","volume":"27","author":"MP Yavropoulou","year":"2020","unstructured":"Yavropoulou MP, Tsoli M, Barkas K, Kaltsas G, Grossman A (2020) The natural history and treatment of non-functioning pituitary adenomas (non-functioning PitNETs). 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