Functional versus Nonfunctional Pituitary Adenomas: A Review of Surgical Outcomes

Objective To determine and compare the surgical outcomes and postoperative complications rates after tumor resection for nonfunctional and functional pituitary tumors.

Methods A retrospective institutional review board approved chart review of 416 patients undergoing transnasal transsphenoidal resection of pituitary tumors over an 8-year period performed by a single otolaryngologist and neurosurgeon. Two cohorts were compared: clinically nonfunctional tumors (NFT) versus clinically functional tumors (FT), which included Cushing's, prolactinomas, and acromegaly. Data included demographics, resection outcomes, and postoperative complications.

Results A total of 294 patients with nonfunctional tumors and 122 patients with functional tumors were identified. The average age for NFT and FT was 56.5 and 39.4 years old, respectively. The median hospital length of stay in the NFT versus FT group was 2 days versus 3 days. The rate of postoperative temporary and permanent diabetes insipidus in the NFT group was 7.1 and 1.4% respectively; in the FT group, it was 6.6 and 2.5%. 8.6% of patients with NFT have residual tumor after resection versus 6.6% of FT patients, without statistical significance. 1.7% of NFT patients had a postoperative a cranial nerve palsy versus 3.2% of FT patients, most of which were present preoperatively, without statistical significance. The rate of deep vein thrombosis in the NFT group was 2.0 versus 3.2% in the FT group, with a rate of 5.5% in the Cushing's patients (2 of 35) (p = 0.12) Finally, the rate of cerebrovascular accident in the NFT group was 1 versus 0.82% in the FT group.

Conclusion While nonfunctional and functional pituitary tumors have some clinically distinct features, our experience with both show that the postoperative complication rates of each group are low and comparable.

Publication History

Publication Date:
02 February 2018 (online)