{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T12:59:07Z","timestamp":1783774747478,"version":"3.55.0"},"reference-count":13,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2015,8,12]],"date-time":"2015-08-12T00:00:00Z","timestamp":1439337600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2015,12]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Context<\/jats:title><jats:p>The natural history and the optimum management of patients with nonfunctioning pituitary adenomas (<jats:styled-content style=\"fixed-case\">NFPA<\/jats:styled-content>s) are unclear.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>Our objective was to characterize the natural history of patients with <jats:styled-content style=\"fixed-case\">NFPA<\/jats:styled-content>s managed conservatively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design and patients<\/jats:title><jats:p>We conducted a retrospective analysis of patients presenting to a tertiary referral centre between 1986 and 2009. Patients with pituitary adenomas and no clinical or biochemical evidence of hormonal hypersecretion were included. Those presenting with apoplexy or a radiological follow\u2010up period of less than 1\u00a0year were excluded. The pituitary imaging for all patients was re\u2010examined by two neuroradiologists in consensus.<\/jats:p><\/jats:sec><jats:sec><jats:title>Outcome measures<\/jats:title><jats:p>The outcome measures were change in tumour size and pituitary hormone function.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Sixty\u2010six patients were managed conservatively for a mean follow\u2010up period of 4\u00b73\u00a0years (range: 1\u201314\u00b77). Forty\u2010seven (71%) had a macroadenoma, and nineteen (29%) had a microadenoma. Tumour size decreased or remained stable in 40% of macroadenomas and 47% of microadenomas. The median annual growth rate of enlarging macroadenomas and microadenomas was 1\u00b70\u00a0mm\/year and 0\u00b74\u00a0mm\/year, respectively. The median annual growth rate of macroadenomas was significantly higher than that of microadenomas (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00\u00b701). Sixty\u2010eight percentage of patients with a macroadenoma had pituitary hormone deficiency in one or more axes, compared to 42% of those with a microadenoma.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Patients with <jats:styled-content style=\"fixed-case\">NFPA<\/jats:styled-content>s without optic chiasm compression can be managed conservatively. All patients need pituitary function assessment, irrespective of tumour size. These findings provide clinically relevant data for the management of patients with <jats:styled-content style=\"fixed-case\">NFPA<\/jats:styled-content>s.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.12860","type":"journal-article","created":{"date-parts":[[2015,7,21]],"date-time":"2015-07-21T15:33:03Z","timestamp":1437492783000},"page":"861-865","source":"Crossref","is-referenced-by-count":30,"title":["Clinical outcomes in patients with nonfunctioning pituitary adenomas managed conservatively"],"prefix":"10.1111","volume":"83","author":[{"given":"Amir H.","family":"Sam","sequence":"first","affiliation":[{"name":"Imperial College Healthcare NHS Trust London UK"},{"name":"Section\u00a0of Investigative Medicine Division of Diabetes, Endocrinology and Metabolism Imperial College London Hammersmith Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sachit","family":"Shah","sequence":"additional","affiliation":[{"name":"Imperial College Healthcare NHS Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keenan","family":"Saleh","sequence":"additional","affiliation":[{"name":"Section\u00a0of Investigative Medicine Division of Diabetes, Endocrinology and Metabolism Imperial College London Hammersmith Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jay","family":"Joshi","sequence":"additional","affiliation":[{"name":"Section\u00a0of Investigative Medicine Division of Diabetes, Endocrinology and Metabolism Imperial College London Hammersmith Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico","family":"Roncaroli","sequence":"additional","affiliation":[{"name":"Division of Brain Sciences Imperial College London London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Robinson","sequence":"additional","affiliation":[{"name":"Imperial College Healthcare NHS Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremy","family":"Cox","sequence":"additional","affiliation":[{"name":"Imperial College Healthcare NHS Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niamh M.","family":"Martin","sequence":"additional","affiliation":[{"name":"Imperial College Healthcare NHS Trust London UK"},{"name":"Section\u00a0of Investigative Medicine Division of Diabetes, Endocrinology and Metabolism Imperial College London Hammersmith Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nigel","family":"Mendoza","sequence":"additional","affiliation":[{"name":"Imperial College Healthcare NHS Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karim","family":"Meeran","sequence":"additional","affiliation":[{"name":"Imperial College Healthcare NHS Trust London UK"},{"name":"Section\u00a0of Investigative Medicine Division of Diabetes, Endocrinology and Metabolism Imperial College London Hammersmith Hospital London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amrish","family":"Mehta","sequence":"additional","affiliation":[{"name":"Imperial College Healthcare NHS Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Waljit S.","family":"Dhillo","sequence":"additional","affiliation":[{"name":"Imperial College Healthcare NHS Trust London UK"},{"name":"Section\u00a0of Investigative Medicine Division of Diabetes, Endocrinology and Metabolism Imperial College London Hammersmith Hospital London 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