The Joint Annual Scientific Meetings of the Endocrine Society of Australia and the Society for Reproductive Biology 2018

Outcomes of pituitary surgery at the Gold Coast University Hospital; the rates of cure for pituitary adenomas, need for subsequent therapy and post-operative hypopituitarism  (#232)

Melissa Katz 1 , Pakeeran Siriratnam 2 , Peter Davoren 3
  1. Endocrinology and Diabetes, Cairns Hospital, Cairns , Queensland, Australia
  2. Ballarat Base Hospital , Ballarat , Victoria , Australia
  3. Endocrinology and Diabetes , Gold Coast University Hospital , Gold Coast , Queensland , Australia

Background:

Surgery has a major role in the treatment of pituitary adenomas, however risks damage to the optic chiasm and loss of normal pituitary function, the very outcomes treatment aims to prevent.

Aims:

To determine the outcomes of pituitary surgery at the Gold Coast University Hospital (GCUH) and compare it to other health services both nationally and internationally.

Methods:

HBCIS coding was used to identify patients discharged from the GCUH between January 2000 and May 2016 who had a "pituitary procedure".  A retrospective chart review was then conducted to gather information regarding patient demographics, type of tumour, pre-operative and post-operative anterior pituitary function and other surgical outcomes.

Results:

Results are available for 94 patients; 86 patients who had their first operation at the GCUH and 8 patients who had initial treatment elsewhere. The majority (76.6%) of patients had a non-secretory adenoma. After 1 surgery, 76.6% of patients with a non-secretory adenoma were in remission with 21.9% of patients requiring a subsequent operation and 6.3% radiation. For patients with secreting pituitary tumours 27.3% were cured after one operation. New pituitary dysfunction developed in 20.9%. Post operative diabetes inspidus occurred in 13.0%, but it was permanent in only 1.7%. CSF leak (19.1%) was the most common surgical complication.

Conclusions:

Patients in this study experienced similar rates of tumour control to other studies. The rates of anterior pituitary dysfunction in this population group were comparable to other Australian studies but higher than international findings.