Transsfenoïdale resectie van hypofyseadenomen: langetermijnresultaten van het Leids Universitair Medisch Centrum

Objective

To evaluate the long-term outcome of transsphenoidal resection of pituitary adenomas at the Leiden University Medical Center (LUMC), the Netherlands.

Design

Retrospective, descriptive.

Method

416 consecutive patients undergoing surgery for pituitary adenoma at the LUMC between 1978 and 2004 were included; 174 patients with non-functioning macroadenomas (NFMA), 164 patients with acromegaly and 78 patients with Cushing’s disease.

Results

Biochemical remission was achieved in 66 of patients with acromegaly, and 72 of patients with Cushing’s disease; incidence of pituitary failure was low in these patients (5 and 18 respectively). In 82 of the patients with NFMA visual function improved whereas the percentage with any degree of pituitary failure increased from 85 (preoperatively) to 95 (postoperatively). During follow-up of 10-15 years, the recurrence rate for acromegaly and Cushing’s disease was 9 and for NFMA it was 15.

Conclusion

Transsphenoidal resection is an effective treatment in most, but not all, patients with pituitary adenomas. The surgical results at the LUMC are comparable with those obtained in important international centres. All patients cured by surgery need lifelong follow-up, because of the real risk of recurrent disease.

Ned Tijdschr Geneeskd. 2008;152:2565-70