BACKGROUND: Non-functioning pituitary adenomas (NFAs) are slow-growing tumours with reported re-growth rates following surgical resection alone of up to 50% at 10 years. Currently, the desired length of follow-up surveillance imaging in un-irradiated patients is unclear. AIM: To clarify the timing of re-growth in patients with NFAs, treated solely by surgery without post-operative pituitary radiotherapy, and also to clarify whether continued imaging is necessary in these patients. METHODS: A case note analysis of all patients who underwent surgery alone for NFA between January 1984 and December 2007 was undertaken. Patients were followed for a minimum of 1 year. Re-growth was diagnosed on the basis of radiological appearances with or without associated manifestations. RESULTS: One hundred and fifty-five patients (94 males, mean age at diagnosis 57.9 (range 18.3-88) years) were included. Twenty-nine were followed up for more than 10 years. The mean follow-up following surgery was 6.1 years (median 4.3 (range 1-25.8)). Re-growth was documented in 54 (34.8%) cases and 20.4% of these cases showed relapse/re-growth 10 or more years after the initial surgery. Kaplan-Meier analysis showed relapse rates of 23.1, 46.7 and 67.9% at 5, 10 and 15 years respectively. There was a significant increase in the re-growth rates if there was either pituitary tumour remnant observed on the first post-operative scan (P≤0.001) or a younger age at initial surgery (P=0.034). CONCLUSION: These results suggest that patients with NFAs need to be closely monitored following surgery, particularly those with post-operative tumour remnants. With 20% of relapse occurring after 10 years, follow-up surveillance needs to be continued beyond this time.
BACKGROUND: Non-functioning pituitary adenomas (NFAs) are slow-growing tumours with reported re-growth rates following surgical resection alone of up to 50% at 10 years. Currently, the desired length of follow-up surveillance imaging in un-irradiated patients is unclear. AIM: To clarify the timing of re-growth in patients with NFAs, treated solely by surgery without post-operative pituitary radiotherapy, and also to clarify whether continued imaging is necessary in these patients. METHODS: A case note analysis of all patients who underwent surgery alone for NFA between January 1984 and December 2007 was undertaken. Patients were followed for a minimum of 1 year. Re-growth was diagnosed on the basis of radiological appearances with or without associated manifestations. RESULTS: One hundred and fifty-five patients (94 males, mean age at diagnosis 57.9 (range 18.3-88) years) were included. Twenty-nine were followed up for more than 10 years. The mean follow-up following surgery was 6.1 years (median 4.3 (range 1-25.8)). Re-growth was documented in 54 (34.8%) cases and 20.4% of these cases showed relapse/re-growth 10 or more years after the initial surgery. Kaplan-Meier analysis showed relapse rates of 23.1, 46.7 and 67.9% at 5, 10 and 15 years respectively. There was a significant increase in the re-growth rates if there was either pituitary tumour remnant observed on the first post-operative scan (P≤0.001) or a younger age at initial surgery (P=0.034). CONCLUSION: These results suggest that patients with NFAs need to be closely monitored following surgery, particularly those with post-operative tumour remnants. With 20% of relapse occurring after 10 years, follow-up surveillance needs to be continued beyond this time.
Authors: Navid Redjal; Andrew S Venteicher; Danielle Dang; Andrew Sloan; Remi A Kessler; Rebecca R Baron; Constantinos G Hadjipanayis; Clark C Chen; Mateo Ziu; Jeffrey J Olson; Brian V Nahed Journal: J Neurooncol Date: 2021-02-21 Impact factor: 4.130
Authors: Valerie Panet-Raymond; Kushraw Sabit; George Shenouda; Denis Sirhan; Anthony Zeitouni; Luis Souhami Journal: J Neurol Surg B Skull Base Date: 2018-10-10
Authors: Heather M Kistka; Rebecca A Kasl; Arash Nayeri; Andrea L Utz; Kyle D Weaver; Lola B Chambless Journal: J Neurol Surg B Skull Base Date: 2015-05-08
Authors: Iris Crespo; Alicia Santos; Eugenia Resmini; Elena Valassi; Maria Antonia Martínez-Momblán; Susan M Webb Journal: Eur Endocrinol Date: 2013-03-15