Observation alone after transsphenoidal surgery for nonfunctioning pituitary macroadenoma

The Journal of Clinical Endocrinology and Metabolism
O M DekkersJ A Romijn

Abstract

Transsphenoidal surgery is the treatment of choice for nonfunctioning pituitary macroadenomas (NFMA). In this study we evaluated the long-term effects of a treatment strategy in which postoperative radiotherapy was not routinely applied to patients with NFMA. This was a retrospective follow-up study. We included 109 consecutive patients (age 56 +/- 13 yr) operated for NFMA between 1992 and 2004. Radiological imaging revealed a macroadenoma in all patients, with suprasellar extension in 96% and parasellar/infrasellar extension in 36% of cases. Visual field defects were present in 87% of the patients and improved in 84% of these patients after surgery. Only six patients received postoperative radiotherapy. Ten patients died during the follow-up period. Ninety-seven patients could be assessed for tumor regrowth or tumor recurrence after a mean follow-up period of 6.0 +/- 3.7 yr. In nine patients there was evidence for tumor regrowth, and in one patient tumor recurrence was observed. The mean time to tumor growth/recurrence after initial therapy was 6.9 (range 3-12) yr. Follow-up duration was found to be an independent predictor for tumor regrowth. Transsphenoidal surgery without postoperative radiotherapy is an effective and safe ...Continue Reading

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Citations

Nov 4, 2006·Pituitary·Craig A Jaffe
Feb 21, 2008·Pituitary·Andrew A KannerYona Greenman
Nov 23, 2013·Clinical Neurology and Neurosurgery·Mahmoud MessererEmmanuel Jouanneau
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