title: Microneurosurgery and subsequent gamma knife radiosurgery for functioning pituitary macroadenomas or giant adenomas: One institution's experience.
abstract: OBJECTIVE
  Functioning pituitary macroadenoma and giant adenoma have large growth volumes and endocrinological abnormalities, requiring proper medical intervention. In this retrospective study, microneurosurgery and subsequent gamma knife radiosurgery (GKRS) is assessed for efficacy and safety for the treatment of functioning pituitary macroadenoma and giant adenoma.
  
  
  METHODS
  Between January 2007 and December 2011, 59 patients with functioning pituitary macroadenoma (n=38) or giant adenoma (n=21) received microneurosurgical resection, and after three months, GKRS with average maximum radiation dose ∼42Gy (range 30-66.7Gy). The median follow-up time was 54.3 months (range 36-85 months).
  
  
  RESULTS
  The combined treatment controlled tumor growth in 81.4% (48/59) of patients, and improved the endocrinological status in 64.4% (38/59). Complications included hypopituitarism and visual deterioration (22 and 7 patients, respectively). Large tumor size at presentation was a risk factor for tumor recurrence, but not age, gender, invasion, radiosurgical dose, pituitary hormone status or follow-up period. Better outcomes were achieved by patients with macroadenoma than giant adenoma.
  
  
  CONCLUSIONS
  Combined microneurosurgery and GKRS are safe and effective for functioning pituitary macroadenomas or giant adenomas. Tumor control and endocrinological improvement were satisfactory, with minimal complications.
authors.affiliation: Department Of Neurosurgery, Union Hospital, Tongji Medical College, Huazhong University Of Science and Technology, Wuhan 430022, China.
authors.forename: Peng
authors.initials: P
authors.lastname: Fu
authors.affiliation: Department Of Neurosurgery, Union Hospital, Tongji Medical College, Huazhong University Of Science and Technology, Wuhan 430022, China.
authors.forename: Yun-Song
authors.initials: YS
authors.lastname: He
authors.affiliation: Department Of Neurosurgery, Union Hospital, Tongji Medical College, Huazhong University Of Science and Technology, Wuhan 430022, China.
authors.forename: Yong-Cun
authors.initials: YC
authors.lastname: Cen
authors.affiliation: Department Of Rehabilitation Medicine, Union Hospital, Tongji Medical College, Huazhong University Of Science and Technology, Wuhan 430022, China.
authors.forename: Qin
authors.initials: Q
authors.lastname: Huang
authors.affiliation: Department Of Neurosurgery, Union Hospital, Tongji Medical College, Huazhong University Of Science and Technology, Wuhan 430022, China.
authors.forename: Ke-Tai
authors.initials: KT
authors.lastname: Guo
authors.affiliation: Department Of Neurosurgery, Union Hospital, Tongji Medical College, Huazhong University Of Science and Technology, Wuhan 430022, China.
authors.forename: Hong-Yang
authors.initials: HY
authors.lastname: Zhao
authors.affiliation: Department Of Neurosurgery, Union Hospital, Tongji Medical College, Huazhong University Of Science and Technology, Wuhan 430022, China. Electronic address: xiangwei19730320@163.com.
authors.forename: Wei
authors.initials: W
authors.lastname: Xiang
mesh_terms: D000236:Adenoma / Q000532:radiotherapy* / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008866:Microsurgery / Q000009:adverse effects / Q000379:methods; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000009:adverse effects / Q000379:methods*; D010911:Pituitary Neoplasms / Q000532:radiotherapy* / Q000601:surgery*; D016634:Radiosurgery / Q000009:adverse effects / Q000379:methods; D016896:Treatment Outcome; D055815:Young Adult
keywords: Adenohypophyseal cells; Hormonal data; Microneurosurgery; Pituitary adenomas