Prognostic Factors in Cancer Patients with Symptomatic Pituitary Metastasis: A Clinical Case Study

Background/Aim: Pituitary metastasis has a rare and indolent course that impedes early diagnosis and treatment. Nevertheless, local tumor control may improve survival. However, few studies provide information regarding the prognosis of patients with pituitary metastases. We aimed to determine these prognostic factors. Patients and Methods: We retrospectively reviewed clinical presentation, diagnosis and management of patients with pituitary metastases. Data were collected at a single Institution between January 1990 and March 2013 and the prognostic factors were analyzed. Results: Eighteen patients with symptomatic pituitary metastasis were reviewed. The median survival was 4.1 months after the diagnosis of pituitary metastasis. Solitary pituitary metastasis and good performance status (Eastern Cooperative Oncology Group (ECOG) score <= 2) had prognostic value but not age, gender or primary tumor type. Patients receiving local therapy for pituitary metastasis had significantly longer survival (6.52 versus 0.9 months, p=0.0143), regardless of ECOG status (16.9 versus 4.3 months, p=0.09 in ECOG <= 2; 2.7 versus 0.8 months, p=0.08 in ECOG >2). Conclusion: Despite the dismal prognosis of patients with pituitary metastases, having a solitary pituitary metastasis, good performance status and receiving local therapy can prolong survival.