ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Endocrine Abstracts (2017) 50 P294 | DOI: 10.1530/endoabs.50.P294

Outcomes of endoscopic, endo-nasal, trans-sphenoidal pituitary adenoma surgery for Acromegaly and Cushing's disease: A single UK centre experience

SM Pearson1, SA Alavi2, K Seejore1, JMW Robins2, A Tyagi2, P Nix3, T Wilson3, N Phillips2, SM Orme1 & RD Murray1


1Leeds centre for diabetes and endocrinology, Leeds teaching hospitals NHS trust, Leeds, UK; 2Department of neurosurgery, Leeds teaching hospitals NHS trust, Leeds, UK; 3Department of ear, nose and throat surgery, Leeds teaching hospitals NHS trust, Leeds, UK.


Background: Endoscopic trans-sphenoidal surgery is a technical advance for treatment of pituitary tumours. We present the outcomes of patients with Acromegaly or Cushing’s disease undergoing selective pituitary adenomectomy in a regional neurosurgical centre.

Methods: Retrospective cohort study August 2010-August 2017. Imaging, histology and pituitary hormone assessments were collated pre and post-operatively to quantify patient hormonal outcomes.

Results: 25 patients with Acromegaly or Cushing’s disease underwent resection (13 Acromegaly and 12 Cushing’s disease.)

Acromegaly group: - Mean age at surgery - 50.6 years

- 9 patients had no pre-operative hormone deficiency and 4 had a deficiency of 1 hormone. None had multiple hormone deficiencies.

- Post-operatively, at last follow up (mean follow up 38.25 months), 7 patients had no hormone deficiency, 2 were deficient in 1 hormone, and 2 in 2-3 hormones. 1 patient died (unrelated to surgery) and 1 lost to follow up.

- 2 patients required no further adjuvant therapy/surgery and 3 required repeat surgery, one of which was curative. Remaining patients (8) required a combination of radiotherapy and/or medical therapy.

Cushing’s group: - Mean age at surgery - 43.5 years.

- 11 patients had no hormone deficiency pre-operatively and 1 patient had 1 hormone deficiency.

- Post-operatively, at last follow up (mean follow up 32.8 months,) 5 patients had no hormone deficiency, 5 an isolated hormone deficiency, 2 were lost to follow up.

- 6 patients required no further treatment. 3 required re-do surgery, 1 of which was curative. 3 patients needed medical adjuvant treatment.

Conclusion: We present the outcomes of patients following endoscopic trans-sphenoidal surgery for Acromegaly and Cushing’s disease. The need for repeat surgery was low in both groups and when needed, it was not curative in 66% of cases.

There is no significant damage to pituitary gland function as a result of surgery.