Analysis Of The Related Factors Of Post-operative Recurrence Of Pituitary Adenoma

Objectives: Pituitary adenomas are benign tumors of the pituitary gland accounting for about 10 percent of intracranial tumors. Surgery is the most fundamental and effective methods of treatment,but patients remain at risk for tumor recurrence for several years afterwards after operation. The related factors of postoperative recurrence of pituitary adenoma are unclear and has been concerned now. The aim of this paper was to study the related factors of post-operative recurrence of pituitary adenomas, make its recurrence trend forecasts, and take appropriate measures to prevent or reduce the pituitary tumor recurrence.Methods: A retrospective analysis of the clinical data, therapeutic methods and Following-up outcome was performed on patients treated with surgery for pituitary adenomas at the neurosurgery department of First Affiliated Hospital of Dalian Medical University from January 2002 to May 2007. The study population included 183 patients with pituitary adenomas underwent surgery. Determinations of recurrence during the follow-up period were based on uniform criteria. The clinical data, therapeutic methods and Following-up outcome of these patients of pituitary adenomas were recorded and statistically analyzed with logistic regression model. Patients' sex, age, disease duration, headache, visual acuity, endocrine symptom, tumor size, tumor invasion, hypopituitarism, location of tumor, cystic change and(or) apoplexy, operative approach, totally or partly resected, post-operative complications, adjunct therapy after operation were taken as variables. Results:Recurrent tumor after surgery was detected in 37 patients(20.2%). recurrent interval ranged from 11 months to 6 years, with a median of 4.1 years. Logistic regression analysis showed that recurrence after surgery was related to the invasion of adenomas, the resection range and the adjunct therapy after operation All these factors showed significant difference (p < 0.05). Pituitary tumors invasion:β>0, Exp (β)>1, demonstrated the factor may promote the risk of tumor recurrence; the resection range and postoperative adjunct therapy:β<0, Exp (β) <1, demonstrated these two Factors may reduce the risk of recurrence. According to the standard regression coefficient, the factor of the adjunct therapy played the most important role in reducing the recurrence rate of pituitary adenoma. The factor of the non-invasion of adenomas was secondary and the factor of the total resection after surgery was least. Other factors such as age, sex, cystic change and (or) apoplexy and the size were unrelated to the recurrence of pituitary adenomas.Conclusion:Many factors contribute to the postoperative recurrence of pituitary adenomas. So clinical surgeons should understand the related factors of postoperative recurrence of pituitary adenoma correctly and comprehensively. The general assessment of preoperative invasive tumors, complete tumor removal as possible in operation and the adjunct postoperative therapy according to prediction of its recurrent trends can prevent or reduce the pituitary tumor recurrence.