Long-term Follow-up Results in Hormonally Active Pituitary Adenomas After Primary Successful Transsphenoidal Surgery

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Abstract
The long-term results of transsphenoidal surgery for hormonally active pituitary adenomas were assessed in 3 follow-up studies. Eight out of 50 patients with microprolactinomas developed a persisting postoperative re-increase of prolactin levels during an average follow-up period of 4.1 years. None of the 43 acromegalic patients who had achieved a suppression of growth hormone to below 2ng/ml during an oral glucose load shortly after surgery relapsed. However, when the remission criterion was only based on basal growth hormone below 5 ng/ml 4 out of 61 patients showed a re-increase of growth hormone levels to persistently elevated values during an average follow-up period of 6.1 years. 14 out of 66 patients followed-up for an average of 8.2 years after successful primary microadenomectomy for Cushing’s disease developed recurrent hypercortisolism as documented by an abnormal suppression of Cortisol after oral low dose dexamethasone.