Observation alone after transsphenoidal surgery for nonfunctioning pituitary macroadenoma.
J Clin Endocrinol Metab
; 91(5): 1796-801, 2006 May.
Article
in En
| MEDLINE
| ID: mdl-16507632
ABSTRACT
OBJECTIVE:
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.DESIGN:
This was a retrospective follow-up study. PATIENTS We included 109 consecutive patients (age 56 +/- 13 yr) operated for NFMA between 1992 and 2004.RESULTS:
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.CONCLUSION:
Transsphenoidal surgery without postoperative radiotherapy is an effective and safe treatment strategy for NFMA, without evidence for tumor regrowth in 90% of all patients, at least for the duration of follow-up presented in this study. Additional studies are required to exclude higher regrowth and recurrence rates during prolongation of the duration of follow-up.
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Collection:
01-internacional
Database:
MEDLINE
Main subject:
Pituitary Neoplasms
/
Adenoma
/
Neurosurgical Procedures
Type of study:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
Limits:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
J Clin Endocrinol Metab
Year:
2006
Document type:
Article
Affiliation country:
Netherlands