Predictors of short-term outcomes following endoscopic pituitary surgery

Clin Neurol Neurosurg. 2009 Feb;111(2):119-22. doi: 10.1016/j.clineuro.2008.09.010. Epub 2008 Nov 4.

Abstract

Objective: Refinement of endoscopic pituitary surgery requires an understanding of the impact of demographic and surgical variables on outcomes.

Methods: Multivariate logistic regression and ANOVA models were used to explore variables for association with outcomes in a consecutive series of 57 patients undergoing endoscopic pituitary surgery.

Results: The mean duration of surgery was 177 min and was longer in patients with larger tumor size (p=0.03) and presentation with visual symptoms (p=0.02) in univariate analyses. The median duration of hospitalization was 3 days and was longer in patients with larger tumors (p=0.0005). Gross tumor removal was achieved in 89%. Tumor size correlated with extent of tumor removal with an almost 3-fold decrease in complete tumor removal for every 1cm increase in tumor size (p=0.047). High rates of hormonal control (90%) and improvement in visual symptoms (92%) were noted.

Conclusions: High rates of gross tumor removal, hormonal cure and visual field improvement were noted in this series. Markers including tumor size and visual symptoms may be used to stratify patients.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Analysis of Variance
  • Child
  • Endoscopy / methods
  • Female
  • Humans
  • Logistic Models
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Neuroendoscopy / methods*
  • Pituitary Gland / physiopathology
  • Pituitary Gland / surgery*
  • Pituitary Neoplasms / physiopathology
  • Pituitary Neoplasms / surgery*
  • Prognosis
  • Prospective Studies
  • Recovery of Function / physiology
  • Time Factors
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Young Adult