An analysis of curative effect of transsphenoidal surgery on pituitary adenomas and factors related to relapse in the patients with pituitary adenomas

DENG You-shou

doi:10.13798/j.issn.1009-153X.2016.09.008

Abstract：Objective To investigate the curative effect of transsphenoidal surgery on pituitary adenomas and factors influencing relapse in patients with pituitary adenomas. Methods The clinical data of 102 patients with pituitary adenomas treated by transsphenoidal surgery from January, 2009 to January, 2015 were retrospectively analyzed. The relapse-free survival rate of patients with pituitary adenomas treated by transsphenoidal surgery was estimated by Kaplan-Meier and compared by Log-rank test and the factors influencing relapse of the tumors were investigated by Cox proportional hazard regression model. Results After transsphenoidal surgery, the headache disappeared in 81.3% (78/96) patients with preoperative headache, the vision was improved in 92.4% (73/79) patients with preoperative vision descending and the blood glucose returned to normal in 75% (18/34) patients with preoperative high blood glucose. After the surgery, the lactation stopped in 31 patients (83.8%, 31/37) and decreased in 6 patients (16.2%, 6/37) of 37 patients with preoperative lactation. Sixteen patients (15.7%) relapsed into the pituitary adenomas from 12 to 60 months after the surgery. The median relapse-free survival time was 36 months (95%CI: 29.4~42.6). Multivariate Cox regression showed that the risk factors related to the relapse of the tumors included the tumors invasiveness (HR=1.85, 95%CI:1.11~3.11), incomplete resection of the tumor (HR=2.05, 95% CI: 1.04~4.07) and no postoperative adjuvant radiotherapy (HR=2.37, 95% CI: 1.25~4.49). Conclusions Transsphenoidal surgery for pituitary adenomas can significantly relieve patients’symptoms and the overall effect is good. The patients with invasive tumors or residual tumors after the surgery, or without postoperative radiotherapy are more likely to undergo relapse.