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Surgical management of pituitary adenomas: does age matter?

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Abstract

Purpose

Along with increased life expectancy and improvements in the diagnostic tools and techniques, the number of elderly patients with symptomatic pituitary tumors being evaluated for surgery is increasing. To date, contrasting results of the safety and effectiveness of transsphenoidal surgery in patients over 65 years old were published in the medical literature. An investigation concerning the extension of resection, post operative complications and, recovery rate from endocrinological and visual symptoms in elderly patients who underwent transsphenoidal surgery for pituitary adenoma was conducted.

Methods

A retrospective review, which included a series of 81 patients 65 years old or older who underwent endoscopic endonasal surgery for pituitary adenomas was analyzed. Pre operative and post operative data were collected and patients were then compared among four age groups: 65–69 years old, 70–74 years old, 75–79 years old and 80 years and over. The results were then compared with the findings from the medical literature review.

Results

The statistical analysis failed to highlight any difference in terms of clinical presentation or complications among the four age groups, however there seems to be a slightly higher risk of post operative hypopituitarism in patients over 74 years old.

Conclusion

The results of the study seem to confirm that transsphenoidal surgery for PA is safe and effective among patients that are 65 and over. Moreover, a partial resection is preferred over a gross total one in order to reduce the surgical risk.

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Abbreviations

ACTH:

Adrenocorticotrop hormone

ASA:

American Society of Anesthesiologists

CSF:

Cerebrospinal fluid

DI:

Diabetes insipidus

GH:

Growth hormone

GTR:

Gross total resection

LHS:

Length of hospital staying

NFPA:

Non functioning pituitary adenoma

PA:

Pituitary adenoma

PR:

Partial resection

PTS:

Patients

STR:

Subtotal resection

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Funding

This research did not receive any specific Grant from funding agencies in the public, commercial, or not-for-profit sectors.

Author information

Authors and Affiliations

  1. Department of Surgical Sciences, University of Torino, 10126, Turin, Italy

    Valentina Tardivo

  2. Neurosurgery Unit, Ente Ospedaliero Galliera, Genoa, Italy

    Valentina Tardivo

  3. Department of Neuroscience “Rita Levi Montalcini”, Neurosurgery Unit, University of Torino, 10126, Turin, Italy

    Federica Penner, Diego Garbossa, Giuseppe Di Perna, Paolo Pacca, Luca Salvati & Francesco Zenga

  4. Department of Anatomy, Biology and Genetics, Legal Medicine, Neuroscience, Diagnostic Pathology, Hygiene and Public Health (DANA) “Gian Filippo Ingrassia”, Univeristy of Catania, Catania, Italy

    Roberto Altieri

  5. Division of Endocrinology, Diabetes and Metabolism, Department of Medical Science, University of Torino, Turin, Italy

    Silvia Grottoli

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  1. Valentina Tardivo
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  2. Federica Penner
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Correspondence to Valentina Tardivo.

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Tardivo, V., Penner, F., Garbossa, D. et al. Surgical management of pituitary adenomas: does age matter?. Pituitary 23, 92–102 (2020). https://doi.org/10.1007/s11102-019-01014-1

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