Document Detail


Transsphenoidal adenomectomy for GH-, PRL- and ACTH-secreting pituitary tumours: outcome analysis in a series of 125 patients.
MedLine Citation:
PMID:  15624082     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
V Esposito; A Santoro; G Minniti; M Salvati; G Innocenzi; G Lanzetta; G Cantore
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology     Volume:  25     ISSN:  1590-1874     ISO Abbreviation:  Neurol. Sci.     Publication Date:  2004 Dec 
Date Detail:
Created Date:  2004-12-29     Completed Date:  2005-01-19     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  100959175     Medline TA:  Neurol Sci     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  251-6     Citation Subset:  IM    
Affiliation:
Department of Neurological Sciences, IRCCS-NEUROMED, University of Rome La Sapienza, Parco Tecnologico, Via Atinense, I-86077 Pozzilli (IS), Italy.
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MeSH Terms
Descriptor/Qualifier:
Acromegaly
Adenoma / metabolism*,  surgery*
Adrenocorticotropic Hormone / metabolism*
Adult
Female
Follow-Up Studies
Human Growth Hormone / metabolism*
Humans
Male
Neurosurgical Procedures*
Pituitary Neoplasms / metabolism*,  surgery*
Prolactin / metabolism*
Retrospective Studies
Sphenoid Bone
Treatment Outcome
Chemical
Reg. No./Substance:
12629-01-5/Human Growth Hormone; 9002-60-2/Adrenocorticotropic Hormone; 9002-62-4/Prolactin

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