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Risk factors for tumor recurrence and progression of spindle cell oncocytoma of the pituitary gland: a systematic review and pooled analysis

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Abstract

Introduction

Spindle cell oncocytoma (SCO) is an extremely rare sellar neoplasm. No observational studies have been reported so far to investigate the prognostic factors of this tumor entity. This systematic review aimed to elucidate the risk factors for tumor recurrence/progression of SCO.

Methods

We searched for relevant articles in PubMed and Web of Science. Studies providing individual patient data with follow-up information of SCO cases were included. Pearson’s Chi square and Fisher’s exact test were used for categorical variables while t test or Mann–Whitney tests were applied for continuous variables, if applicable. We used the Cox regression model to assess the effects of suspected variables on progression-free survival (PFS).

Results

A total of 38 case reports and case series comprising of 67 SCOs were included for final analyses. Recurrent/progressive tumors were noted in 38.8% of cases. Among the clinicopathological factors, only the extent of surgery was a significant risk factor for tumor recurrence/progression. SCO patients with a subtotal resection had a significantly higher risk for tumor relapse in comparison with complete removal (HR 7.51; 95% CI 1.75–32.31; p = 0.007).

Conclusion

Our study demonstrated the characteristic clinicopathological features of SCOs with a high recurrence/progression rate and outlined the predictor for tumor relapse. Failure to achieve gross total resection is the only risk factor for tumor recurrence/progression.

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Abbreviations

CI:

Confidence interval

GTR:

Gross total resection

IPD:

Individual patient data

HR:

Hazard ratio

PFS:

Progression-free survival

SCO:

Spindle cell oncocytoma

STR:

Subtotal resection

TCR:

Transcranial resection

TSR:

Transsphenoidal resection

TTF-1:

Thyroid transcription factor-1

WHO:

World Health Organization

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Authors and Affiliations

  1. Department of Pathology, Oklahoma University Health Sciences Center, Oklahoma City, OK, 73104, USA

    Huy Gia Vuong

  2. Stephenson Cancer Center, Oklahoma University Health Sciences Center, Oklahoma City, OK, 73104, USA

    Huy Gia Vuong

  3. Department of Pathology, Cho Ray Hospital, Ho Chi Minh City, 700-000, Viet Nam

    Truong Phan Xuan Nguyen

  4. Faculty of Medicine, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, 700-000, Vietnam

    Nguyen Pham

  5. Department of Neurosurgery, Oklahoma University Health Sciences Center, Oklahoma City, OK, 73104, USA

    Ian F. Dunn

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  1. Huy Gia Vuong
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  2. Truong Phan Xuan Nguyen
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  3. Nguyen Pham
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  4. Ian F. Dunn
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Contributions

HGV: conceptualization, data curation, formal analysis, investigation, methodology, project administration, software, validation, supervision, writing-review, and editing. TPXN: data curation, formal analysis, investigation, software, supervision, writing-review, and editing. NP: data curation, formal analysis, investigation, validation, supervision, writing-review, and editing. IFD: conceptualization, data curation, formal analysis, investigation, methodology, project administration, software, validation, supervision, writing-review, editing, and supervision.

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Correspondence to Ian F. Dunn.

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Vuong, H.G., Nguyen, T.P.X., Pham, N. et al. Risk factors for tumor recurrence and progression of spindle cell oncocytoma of the pituitary gland: a systematic review and pooled analysis. Pituitary 24, 429–437 (2021). https://doi.org/10.1007/s11102-020-01110-7

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