Giant Pituitary Adenoma: Long-Term Outcome after Surgical Treatment of 61 Cases.
- Author:
Chi Heon KIM
1
;
Chae Yong KIM
;
Dong Gyu KIM
;
Dae Hee HAN
;
Je G CHI
;
Hee Won JUNG
Author Information
1. Department of Neurosurgery, Seoul National University, Seoul, Korea. hwjung@snu.ac.kr
- Publication Type:Original Article
- Keywords:
Giant pituitary adenoma;
Radiotherapy;
Transsphenoidal approach
- MeSH:
Adenoma;
Craniotomy;
Follow-Up Studies;
Humans;
Pituitary Neoplasms*;
Radiotherapy;
Retrospective Studies
- From:Journal of Korean Neurosurgical Society
2003;34(2):91-95
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: The authors perform a retrospective analysis in order to evaluate long-term outcome results after surgical treatment of giant pituitary adenoma (PA) and to suggest the optimal treatment strategies. METHODS: From 1990 to 2001, we experienced 61 cases of giant PA, the mean size was 4.8cm. The mean follow-up period was 47 months. There were 30 cases of functioning PA and 43 of invasive adenomas. Transsphenoidal approach (TSA) was performed in 47 patients, craniotomy in 6, and a staged operation (TSA followed by craniotomy) in 8. Gross total/near total removal (over 95% removal) was performed in 9 patients (TSA in 8 and craniotomy in one) and subtotal removal (over 50% and less than 95%) in the others. Post-operative radiotherapy (RTx) was performed in thirty-six patients. Treatment results were classified as controlled and non-controlled group. Controlled group was defined as patients with no evidence of mass growth, improvement of mass effect, and endocrinological normalization. RESULTS: Tumor control was possible in 58% and mass control only was observed in 91%. Additive radiotherapy showed a significant benefit on tumor control (p=0.013) in the subtotal removal group. In patients with functioning PA, endocrinological improvement (normalization 32%) was shown in 92% (Radiotherapy, 20 cases). CONCLUSION: Total removal of giant PAs through TSA or craniotomy is not always feasible and often risky. Subtotal resection of giant PAs by TSA with or without subsequent RTx may provide a good local tumor control.
