{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T15:35:44Z","timestamp":1791387344480,"version":"4.3.3"},"reference-count":33,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,9,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>Nonfunctioning pituitary adenomas (NFPAs) present at a wide range of ages; it is possible that variable outcomes are based on patient age at presentation. This study aimed to explore long-term outcomes of patients with NFPAs following endonasal transsphenoidal surgery (ETS), considering age stratification.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>This retrospective study included 228 patients with NFPAs who underwent ETS, with a median follow-up period of 63 months. The outcomes included progression-free survival (PFS) rates and neurological and endocrinological outcomes. Age-stratified Kaplan-Meier and Cox proportional hazards analyses were performed. Patients were classified into four age groups: \u2264 49, 50\u201359, 60\u201369, and \u2265 70 years.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>Age-stratified analysis showed a significant correlation between age and PFS in NFPAs (5-year PFS rates: 63.0% in those \u2264 49 years, 76.7% in those 50\u201359 years, 85.0% in those 60\u201369 years, and 88.1% in those \u2265 70 years; p = 0.001, log-rank test). Bivariate (HR 1.03, 95% CI 1.01\u20131.05; p = 0.001) and multivariable (HR 1.03, 95% CI 1.02\u20131.05; p = 0.001) analyses demonstrated that older age was significantly associated with longer PFS. Multivariable analysis also demonstrated that smaller maximum tumor diameter (HR 0.77, 95% CI 0.60\u20130.99; p = 0.036) and gross-total resection (HR 8.55, 95% CI 3.90\u201318.75; p = 0.001) were significantly associated with longer PFS. Multivariable logistic regression analysis demonstrated that only younger age was associated with postoperative improvement of male hypogonadism (HR 0.91, 95% CI 0.84\u20130.99; p = 0.019). Other postoperative neurological and endocrinological outcomes were not significantly associated with age.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>Older patients with NFPAs treated with ETS demonstrated a longer PFS. Of endocrinological outcomes studied, only male hypogonadism improvement was associated with younger patient age.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2024.1.jns232495","type":"journal-article","created":{"date-parts":[[2024,4,27]],"date-time":"2024-04-27T01:25:50Z","timestamp":1714181150000},"page":"781-789","source":"Crossref","is-referenced-by-count":2,"title":["Correlation of older age with better progression-free survival despite less aggressive resection in nonfunctioning pituitary adenomas"],"prefix":"10.3171","volume":"141","author":[{"given":"Yuki","family":"Shinya","sequence":"first","affiliation":[{"name":"Departments of Neurologic Surgery and"},{"name":"Department of Neurosurgery, The University of Tokyo Hospital, Tokyo, Japan; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John L. 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