Transsphenoidal adenomectomy for GH-, PRL- and ACTH-secreting pituitary tumours: outcome analysis in a series of 125 patients
| Autor: | Maurizio Salvati, Vincenzo Esposito, Giuseppe Minniti, Gualtiero Innocenzi, G. P. Cantore, G. Lanzetta, Antonio Santoro |
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| Rok vydání: | 2004 |
| Předmět: |
Adenoma
Adult Male medicine.medical_specialty medicine.medical_treatment Dermatology Gastroenterology Neurosurgical Procedures Adrenocorticotropic Hormone Pituitary adenoma Internal medicine Sphenoid Bone Acromegaly medicine Humans Cushing's disease Prolactinoma Transsphenoidal surgery Pituitary Neoplasms Retrospective Studies Human Growth Hormone business.industry Retrospective cohort study General Medicine medicine.disease Prolactin Surgery Psychiatry and Mental health Treatment Outcome Female Neurology (clinical) Neurosurgery business Follow-Up Studies Hormone |
| Zdroj: | Neurological Sciences. 25:251-256 |
| ISSN: | 1590-3478 1590-1874 |
| Popis: | Transsphenoidal surgery (TSS) is a well recognised treatment for secreting pituitary adenomas, however a very wide variation of clinical outcomes and recurrence rates has been reported, depending on the different criteria used to define the cure. We reported the clinical outcome of a large series of patients operated on for a secreting pituitary adenoma according to the most recent stringent criteria of biochemical remission nowadays accepted. One hundred and twenty-five consecutive patients with a secreting pituitary adenoma (42 PRL-, 67 GH- and 16 ACTH-secreting adenomas) who were operated on by the two same neurosurgeons were considered for the study. Biochemical remission of disease was achieved in 56% of patients; 78% for patients with microadenoma and 47% for patients with macroadenomas, respectively. No cases of mortality or major immediate postoperative complications were observed. Tumour size, high hormone levels and dural invasion were significantly correlated to a poor surgical outcome. The recurrence rates ranged between 0 and 24%, being higher for PRL-secreting tumours. In conclusion, TSS is safe and effective in secreting pituitary tumours. It is still the first treatment for GH- and ACTH-secreting adenomas, whereas in patients with prolactinomas, surgery should be reserved for cases of resistance or intolerance to dopamine agonists. |
| Databáze: | OpenAIRE |
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