Prognostic implication of size on outcomes of pituitary macroadenoma: a comparative analysis of giant adenoma with non-giant macroadenoma

Muhammad Faraz Raghib, Adnan Salim, Meher Angez, Sanam Mir Ghazi, Shiraz Hashmi, Muhammad Bilal Tariq, Fauzan Hashmi, Saad Bin Anis, Muhammad Shahzad Shamim, Asra Tanwir, Syed Ather Enam

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)

Abstract

Background: Due to the differences in size and invasiveness when compared to non-giant macroadenomas (nGPAs), giant pituitary adenomas (GPAs) are considerably harder to resect. This study aimed to differentiate GPAs from nGPAs, based on the presenting complaints, surgical approaches, peri- and postoperative outcomes. Methods: We retrospectively analyzed cases of pituitary macroadenomas that underwent surgical resection at a tertiary care hospital. GPAs were tumors greater than 4 cm in the largest dimension, while nGPAs were tumors smaller than 4 cm. 55 GPA patients and 70 nGPA patients from 2006 to 2017 were included. Demographic, perioperative, and post-operative outcomes were evaluated. Group comparisons for continuous variables were made using an independent t-test/Mann Whitney U test and categorical data was analyzed on Chi-square/Fisher exact test; a p-value of < 0.05 was considered significant. Results: Visual deterioration was the most common complaint, reported by 61.4% of nGPA patients and 81.8% of GPA patients. The mean extent of gross total resection was 47.1% in nGPA patients and 18.2% in GPA patients (p = 0.001). After surgery, tumor recurrence was seen in 1.4% of nGPA patients and 18.2% of GPA patients (p = 0.001). First re-do surgery was required in 5.7% of nGPA patients and 25.5% of GPA patients (p = 0.004). Conclusion: Compared to nGPAs, GPAs are more likely to present with a higher number of preoperative symptoms, and lesser chances of gross total tumor resection. GPAs are also associated with a higher rate of recurrence, which results in more follow-up procedures. Larger, multi-center longitudinal studies need to be done to validate these findings.

Original languageEnglish
Pages (from-to)491-496
Number of pages6
JournalJournal of Neuro-Oncology
Volume160
Issue number2
DOIs
Publication statusPublished - Nov 2022

Keywords

  • Giant pituitary adenomas
  • Surgery outcomes
  • Tumor resection
  • Tumor surgery

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