Risk factors for tumor recurrence and progression of spindle cell oncocytoma of the pituitary gland: a systematic review
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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 Huy Gia Vuong1,2 · Truong Phan Xuan Nguyen3 · Nguyen Pham4 · Ian F. Dunn5 Accepted: 7 November 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
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. Keywords Spindle cell oncocytoma · Pituitary · Adenohypophysis · Neurohypophysis · Recurrence · Progression Abbreviations CI Confidence interval GTR Gross total resection IPD Individual patient data HR Hazard ratio Electronic supplementary material The online version of this article (https://doi.org/10.1007/s11102-020-01110-7) contains supplementary material, which is available to authorized users.
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
* Ian F. Dunn Ian‑[email protected]
2
Stephenson Cancer Center, Oklahoma University Health Sciences Center, Oklahoma City, OK 73104, USA
Huy Gia Vuong [email protected]
3
Department of Pathology, Cho Ray Hospital, Ho Chi Minh City 700‑000, Viet Nam
Truong Phan Xuan Nguyen [email protected]
4
Faculty of Medicine, Pham Ngoc Thach University of Medicine, Ho Chi Minh City 700‑000, Vietnam
Nguyen Pham [email protected]
5
Department of Neurosurgery, Oklahoma University Health Sciences Center, Oklahoma City, OK 73104, USA
1
Department of Pathology, Oklahoma University Health Sciences Ce
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