ECE2024 Eposter Presentations Pituitary and Neuroendocrinology (214 abstracts)
Long-term outcomes of non-functioning pituitary macroadenomas following surgery
Mirsala Solak 1 , Ivana Kraljevic 1,2 , Roman Brekalo 2 , Tanja Skoric Polovina 1 , Annemarie Balasko 1 , Karin Zibar Tomsic 1 , Hrvoje Popovac 1 , Tina Dusek 1,2 & Darko Kastelan 1,2
1University Hospital Center Zagreb, Department of endocrinology, Zagreb, Croatia; 2School of Medicine, University of Zagreb, Zagreb, Croatia
Background: Systematic or randomised studies on the natural course of non-functioning pituitary macroadenomas after surgery (NFPA) are lacking.
Objectives: This study aimed to evaluate the long-term outcomes of residual NFPA following pituitary surgery.
Methods: In this retrospective study, we included 130 patients with NPFA who underwent pituitary surgery between 2005 and 2018 at University Hospital Centre Zagreb. The median age of participants was 57 (18-78) years, and 65.4% were male. Data on demographics, surgical outcomes, histology, imaging, and management were collected. The median follow-up time was 90.5 (36-223) months after surgery. Patients with less than three years of follow-up were excluded from the study.
Results: The median adenoma size was 29.2 (10-55) mm, and in 58 (44.6%) cases, infiltration into the cavernous sinus was observed. In the group of patients who had complete tumour resection (n=45), ten (22.2%) experienced adenoma recurrence after a median follow-up period of 73.5 (22-216) months. They showed no differences in age, gender, adenoma size, cavernous sinus invasion, or Ki-67 expression when compared to patients without residual adenomas following surgery. Among the 85 (65.4%) patients who had residual adenomas following primary surgery, 13 (15.3%) demonstrated an increase in size after a median follow-up of 44 (16-120) months. These patients tended to be older (P=0.058) and exhibited higher Ki-67 expression (P=0.05) compared to patients with stable residual adenomas.
Conclusion: Our results emphasize the importance of prolonged post-surgical monitoring for patients with NFPA to promptly detect potential tumour recurrence or an increase in residual tumour size, which are common occurrences in this patient group. Such a proactive approach can significantly impact treatment strategies and improve overall patient outcomes.
Keywords: non-functioning pituitary macroadenoma, surgery, residual adenoma, recurrence, long-term
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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