Transsphenoidal surgery for growth hormone-secreting pituitary adenomas in 130 patients.
OBJECTIVE
Transsphenoid surgery is the treatment of choice for growth hormone (GH)-producing pituitary adenomas. The measures that may predict postoperative remission need to be elucidated.


METHODS
Transsphenoid surgery was performed in 163 patients by a single neurosurgeon from 1992 until 2010. Thirty-three patients were lost to follow-up, and the results of the remaining 130 are presented here.


RESULTS
A total of 81.5% of patients obtained a first postoperative day GH level less than 5 μg/L, whereas 60.5% achieved a value less than 2.5 μg/L. A total of 56.9% had achieved both a GH less than 2.5 μg/L and normal insulin-like growth factor I (IGF-I) on delayed follow-up and could be regarded as in remission. Duration of symptoms before surgery, age, preoperative GH, and IGF-I levels did not significantly influence a patient's remission. Analysis showed that cavernous sinus extension and larger tumor size were associated with decreased remission rate, whereas sellar floor invasion or suprasellar extension did not significantly influence remission.


CONCLUSION
The results of our study show that transsphenoid surgery is an optimal treatment modality for GH-secreting pituitary adenoma. Suprasellar or sellar floor invasion, and preoperative GH or IGF-I do not necessarily predict poor outcomes. Large tumor size and cavernous sinus extension contribute to greater recurrence rates.
['Shirvani|Manouchehr|M|', 'Motiei-Langroudi|Rouzbeh|R|']
D000172:Acromegaly D000236:Adenoma D000293:Adolescent D000328:Adult D000368:Aged D016208:Databases, Factual D005260:Female D013006:Growth Hormone D049912:Growth Hormone-Secreting Pituitary Adenoma D006801:Humans D007334:Insulin-Like Growth Factor I D008279:Magnetic Resonance Imaging D008297:Male D008875:Middle Aged D019635:Neurosurgical Procedures D010911:Pituitary Neoplasms D012189:Retrospective Studies D013100:Sphenoid Bone D055815:Young Adult
Transsphenoidal surgery Pituitary adenoma Growth hormone Remission Acromegaly