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68th Annual Meeting of the German Society of Neurosurgery (DGNC)
7th Joint Meeting with the British Neurosurgical Society (SBNS)

German Society of Neurosurgery (DGNC)

14 - 17 May 2017, Magdeburg

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Pituitary adenoma – clinical importance of residuum

Meeting Abstract

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  • Sabah A. Alavi - Leeds General Infirmary, Department of Neurosurgery, Leeds, United Kingdom
  • J. M. W. Robins - Leeds General Infirmary, Department of Neurosurgery, Leeds, United Kingdom
  • Atul Tyagi - Leeds General Infirmary, Department of Neurosurgery, Leeds, United Kingdom
  • Paul Nix - Leeds General Infirmary, Department of Ear, Nose and Throat (ENT) Surgery, Leeds, United Kingdom
  • Nicholas Phillips - Leeds General Infirmary, Department of Neurosurgery, Leeds, United Kingdom

Deutsche Gesellschaft für Neurochirurgie. Society of British Neurological Surgeons. 68. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 7. Joint Meeting mit der Society of British Neurological Surgeons (SBNS). Magdeburg, 14.-17.05.2017. Düsseldorf: German Medical Science GMS Publishing House; 2017. DocMO.28.03

doi: 10.3205/17dgnc171, urn:nbn:de:0183-17dgnc1719

Published: June 9, 2017

© 2017 Alavi et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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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.