Details

Autor(en) / Beteiligte

• Dekkers, O. M
• Pereira, A. M
• Roelfsema, F
• Voormolen, J. H. C
• Neelis, K. J
• Schroijen, M. A
• Smit, J. W. A
• Romijn, J. A

Titel

Observation Alone after Transsphenoidal Surgery for Nonfunctioning Pituitary Macroadenoma

Ist Teil von

• The journal of clinical endocrinology and metabolism, 2006-05, Vol.91 (5), p.1796-1801

Ort / Verlag

Bethesda, MD: Endocrine Society

Erscheinungsjahr

2006

Link zum Volltext

Quelle

Oxford Journals 2020 Medicine

Beschreibungen/Notizen

• 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.