Artikel
Pituitary adenoma – clinical importance of residuum
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Veröffentlicht: | 9. Juni 2017 |
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Gliederung
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Objective: Report the characteristic and long-term outcome of subtotal resection in pituitary adenoma. Design: Retrospective cohort study of a single institute experience. Subjects: 149 patients who underwent endoscopic trans-sphenoidal resection of pituitary adenoma between August 2009 and August 2016.
Methods: Analysis of patient’s demographics, location and volume of tumour residuum on post-operative MR imaging were performed to investigate the clinical importance of tumour residuum.
Results: A total number of 149 patients (92 Male, 57 Female) with mean age of 56 were included in the study. Tumour residuum location and volume were identified in 3-month and subsequent post-op MR. Tumour residuum was found in 135 patients (90%) with mean residuum volume of 1.8 cm3. Residuum in Cavernous sinus, supra Sellar and Para Sellar/Sellar regions were found in 7,10 and 118 cases respectively. Residuum located bilaterally, centrally, on the right and left side in 5,53,46 and 31 respectively. In Follow-up (mean 20.6 months), residuum volume decreased, increased or remained unchanged in 22,18 and 109 respectively. 39 patients (26.1%) with mean residuum volume of 1.7 cm3 had further treatment: 15 Gamma Knife, 17 Radiotherapy and 10 redo surgery. Of those who had redo surgery 2 had adjuvant Gamma knife radiosurgery and one radiotherapy. Mean time from first surgery to redo-surgery was 23 months and to Gamma knife/Radiotherapy was 22 months.
Conclusion: We have investigated multiple risk factors with possible correlation with long-term outcome in sub-total resection of pituitary adenoma. Significant predictors have not been identified. Although residuum was reported in large number of patients, only small proportion needed further treatment within this follow-up period.