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

Antonio Santoro, Giuseppe Minniti, Andrea Ruggeri, Vincenzo Esposito, Marie Lise Jaffrain-Rea, Roberto Delfini

Research output: Contribution to journalArticle

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.

Original languageEnglish
Pages (from-to)513-518
Number of pages6
JournalSurgical Neurology
Volume68
Issue number5
DOIs
Publication statusPublished - Nov 2007

Keywords

  • Acromegaly
  • Cushing disease
  • Pituitary adenoma
  • Prolactinoma
  • Transsphenoidal surgery

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

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