Significant increases of pituitary tumors and resections from 1993 to 2011

Abstract

Background: Pituitary tumors comprise 10% to 15% of all diagnosed intracranial tumors; 90% are adenomas. Though benign, significant morbidity via compression of surrounding structures or aberrant hormone secretion can occur. This study investigated rates of pituitary tumor diagnoses and treatment trends from 1993 to 2011.

Methods: This study was a retrospective review of the 1993 to 2011 Nationwide Inpatient Sample for patients diagnosed with pituitary tumor as well as those patients who underwent pituitary tumor resection. Incidences of pituitary lesions, surgical approaches, and clinical and economic outcomes were evaluated.

Results: The rate of primary and secondary diagnoses of pituitary tumor per 100,000 persons significantly grew over the study period (correlation coefficient = 0.934 and 0.987, respectively, p < 0.001); a significant increase in the number of pituitary resections performed annually (correlation coefficient = 0.942, p < 0.001) were also seen. Admissions with a primary diagnosis of pituitary neoplasm experienced significant decreases in length of stay over time (correlation coefficient = -0.913, p < 0.001) and mortality (correlation coefficient = -0.697, p = 0.001). Interestingly, hospital charges more than triple over the same time span (correlation coefficient = 0.970, p < 0.001). Transfrontal resections decreased linearly with time.

Conclusion: Pituitary tumor diagnoses and resections have grown significantly over the past 20 years. Transsphenoidal surgical resection among this patient population has increased significantly, whereas transfrontal resections have decreased.

Keywords: incidence pituitary tumors; incidentaloma; pituitary incidentaloma; pituitary neoplasm; resection; skull base tumor.