Biochemical remission and recurrence rate of secreting pituitary adenomas after transsphenoidal adenomectomy: long-term endocrinologic follow-up results.

Abstract

BACKGROUND:

Transsphenoidal surgery is safe and effective in patients with secreting pituitary adenomas; however, variable outcomes have been reported according to the different criteria used to define the biochemical remission of hormone hypersecretion. We report the long-term endocrinologic follow-up results of a large cohort of patients who underwent TSS for secreting pituitary adenomas according to the most recent stringent criteria of cure.

METHODS:

Two hundred ten consecutive patients were operated on by TSS between 1995 and 2004 for a secreting pituitary adenoma (65 PRL-, 109 GH-, and 36 ACTH-secreting adenomas) and were considered for the study.

RESULTS:

The overall remission rate was 65% for the whole series, being 64%, 61%, and 75% for PRL-, GH-, and ACTH-secreting adenomas, respectively. Eighty-six percent of microadenomas and 53% of macroadenomas were cured by surgery. Remission rates were significantly higher in GH- and ACTH-secreting pituitary macroadenomas than in macroprolactinomas. At a median follow-up of 56 months, tumor recurrence was 0%, 11%, and 14% for GH-, ACTH-, and PRL-secreting tumors. Tumor size, cavernous sinus invasion, and high hormone levels were negatively correlated to the outcome.

CONCLUSION:

Transsphenoidal surgery remains an effective treatment for secreting pituitary tumors according to the most recent criteria of cure. Patients with PRL- or ACTH-secreting adenomas may recur after apparently successful surgery, thereby justifying long-term careful endocrinologic follow-up.

• Authors: Antonio Santoro, Giuseppe Minniti, Andrea Ruggeri, Vincenzo Esposito, Marie-Lise Jaffrain-Rea, Roberto Delfini
• Journal: Surgical neurology (Surg Neurol) Vol. 68 Issue 5 Pg. 513-8; discussion 518 (Nov 2007) ISSN: 0090-3019 [Print] United States
• PMID: 17961741 (Publication Type: Journal Article)

Chemical References

• Pituitary Hormones, Anterior

Topics

• Adenoma (blood, metabolism, surgery)
• Adolescent
• Adult
• Aged
• Female
• Follow-Up Studies
• Humans
• Hyperpituitarism (blood, etiology, prevention & control)
• Male
• Middle Aged
• Pituitary Hormones, Anterior (blood, metabolism)
• Pituitary Neoplasms (blood, metabolism, surgery)
• Recurrence
• Remission Induction
• Retrospective Studies
• Time Factors
• Treatment Outcome