The clinical features, recurrence risks and surgical strategies of bone invasive pituitary adenomas

• Published in: Clinical neurology and neurosurgery Vol. 201; p. 106455
• Main Authors: Zhu, Haibo, Li, Bin, Li, Chuzhong, Liu, Chunhui, Wang, Xinsheng, Gui, Songbai, Zhao, Peng, Bai, Jiwei, Cao, Lei, Zhang, Yazhuo
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.02.2021; Elsevier Limited
• Subjects: BIPAs; Bone invasive range; Carotid arteries; Clinical features; Endoscopy; Medical imaging; Medical prognosis; Multivariate analysis; Neurology; Patients; Pituitary; Prognosis; Risk factors; Sex; Sinuses; Statistical analysis; Surgery; Surgical strategies; Tumors; Ultrasonic imaging; Beijing China; China; GH; PR; Prognosis; GTR; ICA; ACTH; TSH; PRL; NFPA; STR; Surgical strategies; EES; Clinical features; FPA; PFS; Bone invasive range; BIPAs
• ISSN: 0303-8467; 1872-6968
• DOI: 10.1016/j.clineuro.2020.106455

•BIPAs has the characteristics of high surgical risk, low GTR rate and high recurrence rate.•There was a significant correlation between bone invasive range and sex, tumor volume and tumor regrowth in BIPAs.•Bone invasive range is an independent risk factor for BIPAs regrowth.•The surgical quality and prognosis of BIPAs have greatly improved through application of neuro-endoscopy. Bone invasive pituitary adenomas (BIPAs) show obvious malignant behaviour. The aim of this study was to analyse the clinical features, prognosis, recurrence risks and surgical strategies of BIPAs. Clinical charts and radiological information were reviewed retrospectively in 107 consecutive cases of BIPAs. Transnasal endoscopic surgery was adopted with the goal of removing tumours. Scheduled follow-up was performed. Clinical variable analyses revealed a significant correlation between bone invasive range and sex, tumour volume and tumour regrowth. Gross total resection, subtotal resection and partial resection were achieved in 26 cases (24.3 %), 28 cases (26.2 %) and 53 cases (49.5 %), respectively. There was a significant correlation between nongross total resection and female sex, young age, large tumour volume, bone invasive range, tumour regrowth and functional pituitary adenomas in BIPAs. The tumour regrowth rates at 3 years, 5 years and 10 years were 45.3 %, 76.3 % and 97.5 %, respectively. Kaplan-Meier curve analysis showed that tumour volume, bone invasion range, age, recurrent tumours and tumour resection degree were associated with BIPA regrowth. Multivariate analysis showed that tumour resection degree, bone invasive range, and tumour diameter were independent risk factors for BIPA regrowth. BIPAs have the characteristics of high surgical risk, low GTR rate and high recurrence rate. There was a significant correlation between bone invasive range and sex, tumour volume and tumour regrowth in BIPAs. Bone invasive range is an independent risk factor for BIPA regrowth.