Proliferation Parameters for Pituitary Adenomas

Buchfelder, Michael; Fahlbusch, Rudolf; Adams, Eric F.; Kiesewetter, F.; Thierauf, P

doi:10.1007/978-3-7091-9450-8_7

Cited by 35 publications

(27 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Surgical invasion describes the invasive nature of the tumour as recognised during operation, while histological invasion, although more frequent, can only be demonstrated by investigating the anatomical structures in the vicinity of the tumour. In up to 80% of the cases, dural invasion can be detected, when the basal dura is thoroughly investigated (26,27). In this series, the overall remission rate of non-invasive adenomas was 66.5% and dropped to 23.7% for invasive tumours.…”

Section: Discussionmentioning

confidence: 68%

The outcome of surgery in 668 patients with acromegaly using current criteria of biochemical ‘cure’

Nomikos

Buchfelder²,

Fahlbusch³

2005

eur j endocrinol

Self Cite

450

283

View full text Add to dashboard Cite

Background and aim: The aim of this study was to illustrate the present role of transsphenoidal surgery as primary therapy in GH-secreting adenomas, and to compare the results concerning control of disease with previous series using older criteria of cure. Method: We report on a consecutive series of 688 acromegalic patients treated over a time period of 19 years. Biochemical cure was defined as normalisation of basal GH level, suppression of GH levels to below 1 ng/ml during an oral glucose load and normalisation of IGF-I levels. Of the 506 patients undergoing primary transsphenoidal surgery, a total of 57.3% postoperatively fulfilled the criteria used.Results: The rate of biochemical 'cure' correlated with the magnitude of the initial GH levels, the tumour size and invasion. The overall complication rate was below 2%. Mortality in this series was 0.1% (1 of 688). During a follow-up period of 10.7 years only two recurrences (0.4%) occurred. However, in the patients treated by transcranial surgery and by repeat surgery the cure rate was found to be relatively low (5.2 and 21.3% respectively). Conclusions: These data suggest that surgery remains with very few exceptions the primary treatment of acromegaly for (i) a high cure rate, (ii) low morbidity, (iii) low recurrence rate and (iv) immediate decline of GH. Based on current criteria of cure, recurrences are uncommon. However, cure by surgery alone is improbable in patients harbouring extended, invasive tumours with high secretory activity, in whom further adjuvant treatment is mandatory.

show abstract

Section: Discussionmentioning

confidence: 68%

The outcome of surgery in 668 patients with acromegaly using current criteria of biochemical ‘cure’

Nomikos

Buchfelder²,

Fahlbusch³

2005

eur j endocrinol

Self Cite

450

283

View full text Add to dashboard Cite

show abstract

“…6 The definition of invasiveness and criteria for assessment of IPA are as follows: IPA infiltrates, incorporates, or destroys the normal confines of the pituitary gland, including the diaphragma sellae, the basal dura, or the cavernous sinus. 13,14 Non-invasive tumors simply expand or displace surrounding structures. In either type of tumor, the direction of spread depends on the pathway of least resistance, with upward extension into the suprasellar space being the most common.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic endonasal transsphenoidal surgery for invasive pituitary adenoma

Zhang

Fei

Zhang

et al. 2008

Journal of Clinical Neuroscience

View full text Add to dashboard Cite

“…Large and invasive tumour residuals are the most likely candidates for further progression. Years ago, we could demonstrate that an aggressive tumour growth pattern is associated with an increased proliferative potential of pituitary adenomas (25).…”

Section: Discussionmentioning

confidence: 99%

Influence of GH substitution therapy in deficient adults on the recurrence rate of hormonally inactive pituitary adenomas: a case–control study

Buchfelder

Kann²,

Wüster³

et al. 2007

European Journal of Endocrinology

Self Cite

View full text Add to dashboard Cite

Objective: Several studies documented metabolic and psychological benefits of GH substitution in deficient adults, most of them suffering from benign pituitary adenomas. Since GH substitution is considered to promote tumour regrowth, adequate treatment is performed with some reservation. Therefore, we aimed to elucidate the effect of GH replacement therapy on tumour recurrence following surgery. Methods: In patients with hormonally inactive pituitary adenomas undergoing tumour surgery, a retrospective case-control study was performed. Pre-and postoperative magnetic resonance (MR) images of GH-treated and untreated patients were matched for best fit by two independent observers. The treated patients were retrieved from the surveillance programme of the German KIMS database and the untreated from the database of the Department of Neurosurgery, University of Erlangen. A total of 55 matched pairs were followed for at least 5 years. Tumour recurrence and progression rates were determined according to the postoperative MR. Results: There were 16 tumour progressions in the treatment group and 12 in the control group. Statistical analysis revealed no significant increase in either recurrence (PZ0.317) or progression (PZ0.617) within the follow-up period of 5 years when GH was adequately replaced. Conclusions: This study provides further observational data of substitution therapy in GH-deficient adults with pituitary adenomas. Comparing long-term surgical results, we found no evidence that GH substitution should be withheld in deficient patients. Even residual tumour does not constitute a contraindication to GH replacement. However, since pituitary tumours are slow growing, an observational period of 5 years may not have been long enough to verify any absolute influence on recurrence potential. 157 149-156 European Journal of Endocrinology

show abstract

Proliferation Parameters for Pituitary Adenomas

Cited by 35 publications

References 12 publications

The outcome of surgery in 668 patients with acromegaly using current criteria of biochemical ‘cure’

The outcome of surgery in 668 patients with acromegaly using current criteria of biochemical ‘cure’

Endoscopic endonasal transsphenoidal surgery for invasive pituitary adenoma

Influence of GH substitution therapy in deficient adults on the recurrence rate of hormonally inactive pituitary adenomas: a case–control study

Contact Info

Product

Resources

About