[Natural history study of postoperative residual non-functioning pituitary adenomas].
OBJECTIVE
To observe the postoperative residual non-functioning pituitary adenomas (PR-NFPAs) without postoperative radiotherapy and to analyze the natural history of PR-NFPAs' growth in order to provide a basis for selecting appropriate strategies of clinical treatment.


METHODS
We evaluated the natural history of 20 patients with PR-NFPAs who did not receive postoperative radiotherapy and drug therapy. Through MRI images, the residual tumor volumes of those patients were serially measured. We further calculated the monthly growth rate and the tumor volume doubling time (TVDT) and analyzed the correlations between the patient age, gender, volume of residual tumor, cavernous sinus (CS) invasion and TVDT.


RESULTS
All patients received observation alone. Among which, 17 adenomas increased in volume and 3 remained unchanged during a follow-up period of 7 months to 17 years (mean 3.90 yr). The mean patient age was 41.8 years. As to 17 patients with tumor regrowth, the tumor volume at the beginning of MRI observation period was 4.73 cm(3) and tumor volume at the last MRI observation was 16.98 cm(3). During the mean 4-year follow-up period, the average monthly growth rate of PR-NFPAs was 7.87% and the mean TVDT was 724 days. Such factors as patient age, gender, volume of residual tumor and CS invasion did not affect the TVDT of PR-NFPAs.


CONCLUSIONS
The tumor growth rate of PR-NFPAs is not significantly correlated with the patient gender, age, volume of residual tumor and CS invasion. In conjunctions with the volume of PR-NFPAs and the distance between residual adenoma and optic chiasm, we should take the TVDT into consideration and determine the appropriate and safe follow-up period.
Wu
Zhe-bao
ZB
Department of Neurosurgery, First Affiliated Hospital of Wenzhou Medical College, Wenzhou 325000, China. zhebaowu@yahoo.com.cn
Chen
Yong
Y
Lü
Qing-ping
QP
Wang
Cheng-de
CD
Su
Zhi-Peng
ZP
Wu
Jin-sen
JS
Zheng
Wei-ming
WM
Zhuge
Qi-chuan
QC
D000236:Adenoma / Q000473:pathology*; D000293:Adolescent; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D018365:Neoplasm, Residual / Q000473:pathology*; D010911:Pituitary Neoplasms / Q000473:pathology*; D011184:Postoperative Period; D055815:Young Adult