Table 1 Characteristics and post-operative outcomes of surgical naïve patients (Group A) undergoing endoscopic TSS
Characteristics | Values | |
|---|---|---|
N | 159 | |
Gender | M: 97 (61.0%); F: 62 (39.0%) | |
Mean age at surgery (years) | 59.3 ± 13.3; Range = 21-87 years | |
Presentation | ||
 • Loss of vision | 90 (56.6%) | |
 • Incidental (Asymptomatic) | 27 (17.0%) | |
 • Symptoms of hypopituitarism | 18 (11.3%); (8-Hypogonadism) | |
 • Headaches | 13 (8.2%) | |
 • Apoplexy | 9 (5.7%) | |
 • CN palsy | 2 (1.3%) | |
Emergency | 8 (6- apoplexy, 1-visual loss, 1-CN palsy) | |
Indication for surgery | ||
 • Visual field defect | 104 (65.4%) | |
 • Contact with optic chiasm/ suprasellar extension (sight-threatening) | 33 (20.8%) | |
 • Apoplexy | 9 (5.7%) | |
 • Large tumour volume | 6 (3.8%) | |
 • Enlarging tumour on surveillance | 4 (2.5%) | |
 • CN involvement | 3 (1.9%) | |
Immunohistochemistry | ||
 • Gonadotroph | 84 (52.8%) | |
 • Null Cell | 52 (32.7%) | |
 • Plurihormonal adenoma | 3 (1.9%) | |
 • Silent corticotroph adenoma | 8 (5.0%) | |
 • Silent thyrotroph adenoma | 1 (0.6%) | |
 • Silent somatotroph adenoma | 1 (0.6%) | |
 • Silent lactotroph adenoma | 1 (0.6%) | |
 • Hyperplasia | 1 (0.6%) | |
 • Other (necrotic, infarcted, normal, no tissue) | 8 (5.0%) | |
Post-surgical outcomesa | ||
 Endocrinopathies | At diagnosis (n=101) | Post-operative (n=101) |
  • Normal pituitary function | 24 (23.8%) | 20 (19.8%) |
  • 1-2 anterior pituitary axis deficits | 41 (40.6%) | 43 (42.6%) |
  • ≥ 3 anterior pituitary axis deficits | 36 (35.6%) | 38 (37.6%) |
  • ADH deficiency | 0 | 2 (2.0%) + 2 transient DI |
 Individual pituitary axis | At diagnosis (n=101) | Post-operative (n=101) |
  • GH deficiency | 60 (59.4%) | 71 (70.3%) |
  • LH/ FSH deficiency | 55 (54.5%) | 56 (55.4%) |
  • ACTH deficiency | 33 (32.7%) | 37 (36.6%) |
  • TSH deficiency | 36 (35.6%) | 37 (36.6%) |
Preserved pituitary function (n=101, total cohort) | 60 (59.4%) | |
Pituitary axis recovery (n=77, excluding 24 patients with normal pituitary function pre-op) | 16 (20.8%) | |
New pituitary axis dysfunction (only including patients with 0-3 anterior pituitary axes impaired pre-op, n=83) | 25 (30.1%) | |
Tumour size | ||
 Median tumour volume (cm3) | At diagnosis (n=156) | Post-operative (n=151) |
5.51 IQR: 3.52 – 9.48 | 0.92 IQR: 0.44 – 2.02 | |
 Extent of tumour resection (EOR), median (%), n=151 | 82.3%, IQR: 64.8 – 91.5% | |
 Gross Total Resection (GTR) | 9 (6.0%) | |
 Near-Total Resection (≥90%) | 44 (29.1%), including 9 GTR | |
 Subtotal Resection (75-89.9%) | 53 (35.1%) | |
 Partial Resection (<75%) | 54 (35.8%) | |
Long-term follow-up | ||
 Mean Follow-up (years) | 3.1 ± 2.1 years; Range 0.5-9.6 years | |
 Large tumour remnant, requiring intervention | 14 (8.8%) | |
 Tumour regrowth | 28 (17.6%), of which 24 (15.1%) required intervention | |
Further Treatment | ||
 • Radiotherapy (RT) | 35 (22.0%) External beam RT: 25 (15.7%) Stereotactic radiosurgery: 10 (6.3%) | |
 • Repeat Surgery | 9 (5.7%) | |
Deaths | 11 (6.9%) | |