Academic Journal
Non-functioning pituitary macroadenomas: factors affecting postoperative recurrence, and pre- and post-surgical endocrine and visual function
| العنوان: | Non-functioning pituitary macroadenomas: factors affecting postoperative recurrence, and pre- and post-surgical endocrine and visual function |
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| المؤلفون: | Subramanian, V, Lee, Rachel Su-Min, Howell, Simon, Gregson, Samuel, Lahart, Ian, Kaushal, Kalpana, Pappachan, JM |
| المساهمون: | Department of Endocrinology & Metabolism, Royal Preston Hospital, The Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UK. |
| المصدر: | 73 ; 2 ; 407 ; 415 |
| بيانات النشر: | Springer |
| سنة النشر: | 2021 |
| المجموعة: | University of Wolverhampton: Wolverhampton Intellectual Repository and E-Theses (WIRE) |
| مصطلحات موضوعية: | non-functioning pituitary macroadenoma, NFPA, transsphenoidal resection, recurrence-free survival, visual field defect, Humans, Adenoma, Pituitary Neoplasms, Neoplasm Recurrence, Local, Postoperative Complications, Treatment Outcome, Retrospective Studies, Aged, Middle Aged, Male, Vision, Ocular |
| الوصف: | This is an accepted manuscript of a paper published by Springer on 06/04/2021, available online: https://doi.org/10.1007/s12020-021-02713-1 The accepted manuscript of the publication may differ from the final published version. For re-use please see the publisher's terms and conditions. ; Background: Non-functioning pituitary macroadenomas (NFPAs) with visual field defects are ideally managed by transsphenoidal tumour resection to improve vision, and long-term postsurgical follow up is necessary to monitor for tumour recurrence. Regular updates from global data are necessary for developing optimal management strategies of these tumours. Methods: Pre- and postoperative visual and endocrine profile, imaging characteristics and details of surgical interventions among patients with NFPAs managed between 2008 and 2019 in a UK regional centre were assessed. The radiological and surgical outcomes including postoperative complications, recurrence risk and the factors influencing outcomes also were assessed. Results: 105 cases with mean (SD) age 60.1 (14.3) years and follow-up duration 60 (37) months were studied. 67 (64%) patients were male. Five-year recurrence-free survival rate was 71.5% (95% confidence interval [CI] 62.7% to 81.6%) with 33 (31%) tumour recurrences of whom 20 (60%) received radiotherapy and 9 (27%) underwent further surgery. Younger age, tumour volume, and bilateral cavernous sinus extension were the predictors of recurrence on univariate analysis, while younger age was the only factor on multivariate analysis (Hazard ratio 0.95; 95% CI: 0.92, 0.97). 72/78 patients (92%) with preoperative visual field defects improved after surgery, of whom 27 (35%) had full recovery. 20 (24%) patients had recovery of an abnormal hormone axis. 15 patients (16%) developed perioperative complications such as cerebrospinal fluid leak (12 cases), meningitis (2 cases), and bleeding (2 cases). Conclusions: Five-year recurrence-free survival after transsphenoidal resection for NFPAs was 71.5% with older age at surgery ... |
| نوع الوثيقة: | article in journal/newspaper |
| وصف الملف: | application/pdf |
| اللغة: | English |
| تدمد: | 1355-008X 1559-0100 |
| Relation: | https://link.springer.com/article/10.1007/s12020-021-02713-1; Subramanian, V., Lee, R.S.M., Howell, S. et al. (2021) Non-functioning pituitary macroadenomas: factors affecting postoperative recurrence, and pre- and post-surgical endocrine and visual function. Endocrine 73, pp. 407–415. https://doi.org/10.1007/s12020-021-02713-1; 33822319 (pubmed); http://hdl.handle.net/2436/624634; Endocrine |
| DOI: | 10.1007/s12020-021-02713-1 |
| الاتاحة: | http://hdl.handle.net/2436/624634 https://doi.org/10.1007/s12020-021-02713-1 |
| رقم الانضمام: | edsbas.878D37A9 |
| قاعدة البيانات: | BASE |
| تدمد: | 1355008X 15590100 |
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| DOI: | 10.1007/s12020-021-02713-1 |