{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,7]],"date-time":"2026-02-07T12:54:09Z","timestamp":1770468849339,"version":"3.49.0"},"reference-count":28,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,8,4]],"date-time":"2025-08-04T00:00:00Z","timestamp":1754265600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec><jats:title>Background information<\/jats:title><jats:p>Most of the studies on mortality, survival analysis and predictor variables in patients with non-functioning pituitary adenomas (NFPA) are heterogeneous and limited; and in some cases, they offer contradictory results.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and methods<\/jats:title><jats:p>Our objective was to analyze the survival of 749 patients (46.3% were women) with NFPA, with a mean follow-up of 60.2 months (32.9-120.6) at a tertiary center, from March 2007 to August 2023. Descriptive and inferential statistics were used. Mortality risk was determined in comparison with the Mexican population by calculating the standardized mortality ratio (SMR) with 99% confidence intervals. Survival analysis and Cox proportional hazards (HR) analysis were performed to identify possible predictors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The overall SMR was of 8.86 (99% Confidence Interval [CI] 5.92-13.25, p&amp;lt;0.001), for &amp;lt;60 years-old patients, it was 13.77 (99% CI 7.23-26.23, p&amp;lt;0.001). In men, it was 7.08 (99% CI 3.92-12.80, p&amp;lt;0.001), and in women it was 11. 11 (99% CI 6.41-19.24, p&amp;lt;0.001). Regarding patients with arterial hypertension, we obtained 6.59 (99% CI 3.75-11.56, p&amp;lt;0.001), and with type 2 diabetes, it was 4.63 (99% CI 1.96-10.93, p&amp;lt;0.001). In the Cox analysis for mortality, an adjusted HR of 2.19 (95% CI 1.13-4.26, p=0.02) was observed for arterial hypertension and 1.32 (95% CI 1.00-1.75, p=0.04) for the total number of surgeries. The rest of the variables had no statistically significant association with mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our study shows a higher mortality in patients diagnosed with NFPA compared to the general population. The higher probability of death was found in the presence of predictors such as arterial hypertension and the total number of surgeries.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fendo.2025.1653376","type":"journal-article","created":{"date-parts":[[2025,8,4]],"date-time":"2025-08-04T04:10:42Z","timestamp":1754280642000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Increased mortality in patients with non-functioning pituitary tumors: a study in a tertiary center"],"prefix":"10.3389","volume":"16","author":[{"given":"Guadalupe","family":"Vargas-Ortega","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edgar-Manuel","family":"Ram\u00edrez-Garc\u00eda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lourdes","family":"Balc\u00e1zar-Hern\u00e1ndez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mario Enrique","family":"Rend\u00f3n-Macias","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlos Alfonso","family":"Romero-Gameros","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Baldomero","family":"Gonz\u00e1lez-Virla","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Blas","family":"L\u00f3pez-F\u00e9lix","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erick","family":"Zepeda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric Misael","family":"Estrada-Estrada","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,8,4]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1155\/2015\/756069","article-title":"Clinical characteristics and treatment outcome of 485 patients with nonfunctioning pituitary macroadenomas","volume":"2015","author":"Vargas","year":"2015","journal-title":"Int J Endocrinol"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ecl.2007.10.011","article-title":"Nonfunctioning pituitary tumors and pituitary incidentalomas","volume":"37","author":"Molitch","year":"2008","journal-title":"Endocrinol Metab Clin North Am"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1001\/JAMA.2016.19699","article-title":"Diagnosis and treatment of pituitary adenomas: A review","volume":"317","author":"Molitch","year":"2017","journal-title":"JAMA - J Am Med Assoc"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1007\/S11102-006-0412-9\/METRICS","article-title":"Clinically non-functioning pituitary adenoma","volume":"9","author":"Jaffe","year":"2006","journal-title":"Pituitary"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1530\/ERC-20-0136","article-title":"The natural history and treatment of non-functioning pituitary adenomas (non-functioning PitNETs)","volume":"27","author":"Yavropoulou","year":"2020","journal-title":"Endocr Relat Cancer"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1210\/JC.2010-0537","article-title":"Incidence of pituitary adenomas in Northern Finland in 1992-2007","volume":"95","author":"Raappana","year":"2010","journal-title":"J Clin Endocrinol Metab"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1016\/J.ARCMED.2023.102917","article-title":"Pharmacological treatment of non-functioning pituitary adenomas","volume":"54","author":"Vargas-Ortega","year":"2023","journal-title":"Arch Med Res"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1016\/J.ARCMED.2023.102900","article-title":"Radiotherapy and mortality in pituitary adenomas","volume":"54","author":"Gonz\u00e1lez-Virla","year":"2023","journal-title":"Arch Med Res"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1677\/ERC-08-0231","article-title":"Radiation-induced hypopituitarism","volume":"16","author":"Fernandez","year":"2009","journal-title":"Endocr Relat Cancer"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1155\/2018\/2852710","article-title":"Cardiovascular risk and metabolic syndrome characteristics in patients with nonfunctional pituitary macroadenoma","volume":"2018","author":"Vargas-Ortega","year":"2018","journal-title":"Int J Endocrinol"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-15-0967","article-title":"Mortality in patients with non-functioning pituitary adenoma is increased: systematic analysis of 546 cases with long follow-up","volume":"174","author":"Ntali","year":"2016","journal-title":"Eur J Endocrinol"},{"key":"B12","doi-asserted-by":"publisher","first-page":"203","DOI":"10.1007\/S11102-018-0863-9","article-title":"Mortality in patients with non-functioning pituitary adenoma","volume":"21","author":"Tampourlou","year":"2018","journal-title":"Pituitary"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1210\/JC.2015-1475","article-title":"Excess mortality in women and young adults with nonfunctioning pituitary adenoma: A swedish nationwide study","volume":"100","author":"Olsson","year":"2015","journal-title":"J Clin Endocrinol Metab"},{"key":"B14","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1007\/S11102-007-0018-X","article-title":"Nonfunctioning pituitary adenoma: incidence, causes of death and quality of life in relation to pituitary function","volume":"10","author":"Nielsen","year":"2007","journal-title":"Pituitary"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1007\/S11102-016-0764-8","article-title":"Time trends of mortality in patients with non-functioning pituitary adenoma: a Swedish nationwide study","volume":"20","author":"Olsson","year":"2017","journal-title":"Pituitary"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1210\/JC.2014-3697","article-title":"Cerebrovascular events, secondary intracranial tumors, and mortality after radiotherapy for nonfunctioning pituitary adenomas: a subanalysis from the Dutch National Registry of Growth Hormone Treatment in Adults","volume":"100","author":"Van Varsseveld","year":"2015","journal-title":"J Clin Endocrinol Metab"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)30053-8","article-title":"Hypopituitarism","volume":"388","author":"Higham","year":"2016","journal-title":"Lancet"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.24875\/RME.M23000027","article-title":"Posici\u00f3n del Grupo de Trabajo de Neuroendocrinolog\u00eda respecto a los adenomas de hip\u00f3fisis no funcionantes","volume":"10","author":"Vargas-Ortega","year":"2023","journal-title":"Rev Mexicana Endocrinolog\u00eda Metabolismo y Nutrici\u00f3n"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1007\/S11102-010-0254-3\/METRICS","article-title":"Comparison of three methods for the estimation of the pituitary gland volume using magnetic resonance imaging: A stereological study","volume":"14","author":"Ertekin","year":"2011","journal-title":"Pituitary"},{"key":"B20","unstructured":"Hist\u00f3rico Bolet\u00edn Epidemiol\u00f3gico\n          \n          \n            \n              Garc\u00eda-Rodriguez\n              G\n            \n            \n              Gonzalez-Sanchez\n              R\n            \n            \n              Ceballos-Liceaga\n              S\n            \n            \n              Rojas-Arroyo\n              N\n            \n            \n              L\u00f3pez-Santiago\n              Y\n            \n            \n              Flores Cisneros\n              L\n            \n          \n          Direcci\u00f3n General de Epidemiolog\u00eda\n          Secretar\u00eda de Salud\n          \n          2023"},{"key":"B21","unstructured":"Poblaci\u00f3n total por entidad federativa y grupo quinquenal de edad seg\u00fan sexo, serie de a\u00f1os censales de 1990 a 2020"},{"key":"B22","unstructured":"Defunciones registradas por diabetes mellitus por entidad federativa de residencia habitual de la persona fallecida y grupo quinquenal de edad seg\u00fan sexo, serie anual de 2010 a 2023"},{"key":"B23","unstructured":"Defunciones registradas por entidad federativa de residencia habitual de la persona fallecida seg\u00fan sexo, serie anual de 2010 a 2023"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(00)04006-X","article-title":"Association between premature mortality and hypopituitarism","volume":"357","author":"Tomlinson","year":"2001","journal-title":"Lancet"},{"key":"B25","unstructured":"Principales causas"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1007\/S40618-024-02356-9","article-title":"Excess mortality in patients with non-functioning pituitary adenoma: a systematic review and meta-analysis","volume":"47","author":"Bioletto","year":"2024","journal-title":"J Endocrinol Invest"},{"key":"B27","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1530\/EJE-16-0450","article-title":"Life expectancy in patients with pituitary adenoma receiving growth hormone replacement","volume":"176","author":"Olsson","year":"2017","journal-title":"Eur J Endocrinol"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1007\/S11102-024-01412-0","article-title":"Pituitary apoplexy: a systematic review of non-gestational risk factors","volume":"27","author":"Kajal","year":"2024","journal-title":"Pituitary"}],"container-title":["Frontiers in Endocrinology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2025.1653376\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,4]],"date-time":"2025-08-04T04:10:44Z","timestamp":1754280644000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fendo.2025.1653376\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,4]]},"references-count":28,"alternative-id":["10.3389\/fendo.2025.1653376"],"URL":"https:\/\/doi.org\/10.3389\/fendo.2025.1653376","relation":{},"ISSN":["1664-2392"],"issn-type":[{"value":"1664-2392","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,4]]},"article-number":"1653376"}}