Cabergoline therapy versus repeated surgery in post-operative residual non-functioning pituitary adenomas (NFPA): a 10-year clinical outcome analysis
Introduction Non-functioning pituitary macroadenomas (NFPAs) account for the highest proportion (1/3) of pituitary macroadenomas. Surgery is the primary mode of treatment of NFPAs however recurrence is seen in 50% of cases. There is no standard guideline in terms of treatment modalities for resid...
Saved in:
Main Authors: | , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
Asean Federation Of Endocrine Society
2019
|
Subjects: | |
Online Access: | http://irep.iium.edu.my/84966/7/84966%20Cabergoline%20Therapy%20versus%20Repeated%20Surgery.pdf http://irep.iium.edu.my/84966/ https://www.asean-endocrinejournal.org/index.php/JAFES/article/view/669/1115 |
Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
id |
my.iium.irep.84966 |
---|---|
record_format |
dspace |
spelling |
my.iium.irep.849662020-11-27T03:13:48Z http://irep.iium.edu.my/84966/ Cabergoline therapy versus repeated surgery in post-operative residual non-functioning pituitary adenomas (NFPA): a 10-year clinical outcome analysis Nordin, Normala Haydar Ali Tajuddin, Amalina Kamaruddin, Nor Azmi Osman, Syazarina Sharis Yahaya, Azyani Syed Zakaria, Syed Zulkifli RC Internal medicine RC648 Specialties of Internal Medicine-Diseases of The Endocrine Glands. Clinical Endocrinology Introduction Non-functioning pituitary macroadenomas (NFPAs) account for the highest proportion (1/3) of pituitary macroadenomas. Surgery is the primary mode of treatment of NFPAs however recurrence is seen in 50% of cases. There is no standard guideline in terms of treatment modalities for residual NFPAs with regards to repeat surgery, medical therapy, stereotactic or conventional radiotherapy. Methodology To analyse the clinical outcomes of secondary therapies for residual NFPAs following initial surgery by comparing cabergoline treatment versus repeated surgery and watchful surveillance. Data of patients with residual NFPAs following initial surgery from the endocrine and surgical clinics of Pusat Perubatan Universiti Kebangsaan Malaysia from 1997 to 2016 were retrieved and analysed. A total of 74 patients were enrolled, 30 patients in cabergoline group, 14 patients in repeated surgery group and 30 patients in watchful surveillance group. Results The cabergoline group showed disease control in 86.7% of the patients and repeated surgery showed disease control in 42.9% of the patients (p value=0.002). The watchful surveillance group showed disease progression in 20% of patients compared with repeated surgery, 57.1% (p value=0.014). Complete suprasellar extension (p=0.035), complete parasellar extension (p=0.006) and tumor growth rate >10cm3 were predictive for negative outcomes of secondary therapies. Conclusion Residual tumour size ranging from 110 mm3 to 3, 200 mm3, 86% can be effectively controlled by cabergoline therapy. Patients who underwent repeated surgery tended to have bigger tumours and higher tumour growth rate; hence the outcome of surgery was not good as patients who received cabergoline. Decision to choose smaller size tumours for cabergoline therapy is seemingly justified. Asean Federation Of Endocrine Society 2019-07-17 Article PeerReviewed application/pdf en http://irep.iium.edu.my/84966/7/84966%20Cabergoline%20Therapy%20versus%20Repeated%20Surgery.pdf Nordin, Normala and Haydar Ali Tajuddin, Amalina and Kamaruddin, Nor Azmi and Osman, Syazarina Sharis and Yahaya, Azyani and Syed Zakaria, Syed Zulkifli (2019) Cabergoline therapy versus repeated surgery in post-operative residual non-functioning pituitary adenomas (NFPA): a 10-year clinical outcome analysis. Journal of The Asean Federation Of Endocrine Society (JAFES), 34. p. 4. ISSN 0857-1074 E-ISSN 2308-118X https://www.asean-endocrinejournal.org/index.php/JAFES/article/view/669/1115 |
institution |
Universiti Islam Antarabangsa Malaysia |
building |
IIUM Library |
collection |
Institutional Repository |
continent |
Asia |
country |
Malaysia |
content_provider |
International Islamic University Malaysia |
content_source |
IIUM Repository (IREP) |
url_provider |
http://irep.iium.edu.my/ |
language |
English |
topic |
RC Internal medicine RC648 Specialties of Internal Medicine-Diseases of The Endocrine Glands. Clinical Endocrinology |
spellingShingle |
RC Internal medicine RC648 Specialties of Internal Medicine-Diseases of The Endocrine Glands. Clinical Endocrinology Nordin, Normala Haydar Ali Tajuddin, Amalina Kamaruddin, Nor Azmi Osman, Syazarina Sharis Yahaya, Azyani Syed Zakaria, Syed Zulkifli Cabergoline therapy versus repeated surgery in post-operative residual non-functioning pituitary adenomas (NFPA): a 10-year clinical outcome analysis |
description |
Introduction
Non-functioning pituitary macroadenomas (NFPAs) account for the highest proportion (1/3) of pituitary macroadenomas.
Surgery is the primary mode of treatment of NFPAs however recurrence is seen in 50% of cases. There is no standard
guideline in terms of treatment modalities for residual NFPAs with regards to repeat surgery, medical therapy, stereotactic
or conventional radiotherapy.
Methodology
To analyse the clinical outcomes of secondary therapies for residual NFPAs following initial surgery by comparing
cabergoline treatment versus repeated surgery and watchful surveillance. Data of patients with residual NFPAs following
initial surgery from the endocrine and surgical clinics of Pusat Perubatan Universiti Kebangsaan Malaysia from 1997 to
2016 were retrieved and analysed. A total of 74 patients were enrolled, 30 patients in cabergoline group, 14 patients in
repeated surgery group and 30 patients in watchful surveillance group.
Results
The cabergoline group showed disease control in 86.7% of the patients and repeated surgery showed disease control in
42.9% of the patients (p value=0.002). The watchful surveillance group showed disease progression in 20% of patients
compared with repeated surgery, 57.1% (p value=0.014). Complete suprasellar extension (p=0.035), complete parasellar
extension (p=0.006) and tumor growth rate >10cm3 were predictive for negative outcomes of secondary therapies.
Conclusion
Residual tumour size ranging from 110 mm3 to 3, 200 mm3, 86% can be effectively controlled by cabergoline therapy.
Patients who underwent repeated surgery tended to have bigger tumours and higher tumour growth rate; hence the
outcome of surgery was not good as patients who received cabergoline. Decision to choose smaller size tumours for
cabergoline therapy is seemingly justified. |
format |
Article |
author |
Nordin, Normala Haydar Ali Tajuddin, Amalina Kamaruddin, Nor Azmi Osman, Syazarina Sharis Yahaya, Azyani Syed Zakaria, Syed Zulkifli |
author_facet |
Nordin, Normala Haydar Ali Tajuddin, Amalina Kamaruddin, Nor Azmi Osman, Syazarina Sharis Yahaya, Azyani Syed Zakaria, Syed Zulkifli |
author_sort |
Nordin, Normala |
title |
Cabergoline therapy versus repeated surgery in post-operative residual non-functioning pituitary adenomas (NFPA): a 10-year clinical outcome analysis |
title_short |
Cabergoline therapy versus repeated surgery in post-operative residual non-functioning pituitary adenomas (NFPA): a 10-year clinical outcome analysis |
title_full |
Cabergoline therapy versus repeated surgery in post-operative residual non-functioning pituitary adenomas (NFPA): a 10-year clinical outcome analysis |
title_fullStr |
Cabergoline therapy versus repeated surgery in post-operative residual non-functioning pituitary adenomas (NFPA): a 10-year clinical outcome analysis |
title_full_unstemmed |
Cabergoline therapy versus repeated surgery in post-operative residual non-functioning pituitary adenomas (NFPA): a 10-year clinical outcome analysis |
title_sort |
cabergoline therapy versus repeated surgery in post-operative residual non-functioning pituitary adenomas (nfpa): a 10-year clinical outcome analysis |
publisher |
Asean Federation Of Endocrine Society |
publishDate |
2019 |
url |
http://irep.iium.edu.my/84966/7/84966%20Cabergoline%20Therapy%20versus%20Repeated%20Surgery.pdf http://irep.iium.edu.my/84966/ https://www.asean-endocrinejournal.org/index.php/JAFES/article/view/669/1115 |
_version_ |
1684653112255578112 |
score |
13.19449 |