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Results and risk factors for recurrence following endoscopic endonasal transsphenoidal surgery for pituitary adenoma.

Abstract：

BACKGROUND:Endoscopic endonasal (EE) transsphenoidal surgery is an important surgical approach to the treatment of sellar pathology, particularly for pituitary adenomas. Risk factors for the radiographic recurrence of pituitary adenomas resected using a purely endoscopic approach have not been established. This study investigates outcomes and identifies risk factors for recurrence following EE transsphenoidal surgery for pituitary adenoma. METHODS:We performed a retrospective review of 64 patients with pituitary adenomas undergoing EE surgery by a single, right-handed surgeon preferentially operating through the right nares. Post-operative MRI studies were utilized to monitor for residual disease or disease recurrence. RESULTS:Residual tumor was found in 31.2% of patients. Over a median follow-up period of 23.1 months (range 4-62.5), 4 (20%) of these patients showed recurrence. Two patients with inconclusive post-operative imaging had subsequent imaging consistent with recurrence, making the total recurrence in our series 9.4%. While no statistically significant effects of gender, age or history of previous treatment were seen, amenorrhea on presentation and maximum tumor diameter >10 mm were significant risk factors for radiographic recurrence (p = 0.044 and 0.005, respectively). No predominant side of residual tissue was identified in these tumors operated through the right nares. CONCLUSIONS:Only 20% of patients with residual tumor developed recurrent disease over a median follow up of 23.1 months. This recurrence rate may be an important consideration in cases where gross total resection is not feasible. Preferentially operating from the right does not seem to influence the location of residual tumor.

journal_name

Clin Neurol Neurosurg

journal_title

Clinical neurology and neurosurgery

authors

Bodhinayake I,Ottenhausen M,Mooney MA,Kesavabhotla K,Christos P,Schwarz JT,Boockvar JA

doi

10.1016/j.clineuro.2014.01.020

subject

Has Abstract

pub_date

2014-04-01 00:00:00

pages

75-9

eissn

0303-8467

issn

1872-6968

pii

S0303-8467(14)00033-X

journal_volume

119

pub_type

杂志文章

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Results and risk factors for recurrence following endoscopic endonasal transsphenoidal surgery for pituitary adenoma.