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

Authors

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

Document Type

Article

Department

Neurology; Surgery

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.

Comments

Volume, issue, and pagination are not provided by the author/publisher

Publication (Name of Journal)

Journal of Neuro-Oncology

Recommended Citation

Raghib, M. F., Salim, A., Angez, M., Ghazi, S. M., Hashmi, S., Tariq, M. B., Hashmi, F., Anis, S. B., Shamim, M. S., Tanwir, A., Enam, S. A. (2022). Prognostic implication of size on outcomes of pituitary macroadenoma: A comparative analysis of giant adenoma with non-giant macroadenoma. Journal of Neuro-Oncology.
Available at: https://ecommons.aku.edu/pakistan_fhs_mc_med_neurol/246