What is the prognosis of pituitary macroadenomas?

Updated: Apr 20, 2020
  • Author: James R Mulinda, MD, FACP; Chief Editor: George T Griffing, MD  more...
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Answer

Prognosis is variable depending on patient status, comorbid conditions, tumor size, and functional status of the tumor.

Small, nonfunctioning tumors that undergo curative surgical extirpation have an excellent prognosis compared to unresectable, giant macroadenomas.

Tumors that continue to secrete excess hormone despite aggressive treatment carry a poor prognosis. Such cases include Cushing disease and acromegaly. [30]

A meta-analysis showed that macroadenomas tend to enlarge more frequently (12.5 per 100 patient-years [95% CI 7.9 - 17.2] than microadenomas (3.3 per 100 patient-years [95% CI 2.1-4.5]). [31]

A study by Gerges et al found that in patients who underwent endoscopic endonasal surgery for nonfunctioning pituitary macroadenomas, recurrence probabilities associated with gross-total resection were, at 5 and 10 years, 3.9% and 4.7%, respectively, with a 0.79% and 1.6% probability of needing treatment for recurrence, respectively. In patients who underwent subtotal resection and were not treated with early postoperative radiation, there was a 21% and 24.5% probability of disease progression at 5 and 10 years, respectively, with cavernous sinus location and tumor size greater than 1.0 cm3 being risk factors for progression. [32]


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