Treatment and recurrences in 135 pituitary adenomas

In 135 operated pituitary adenomas of different histological nature, seen over 20 years, the initial treatment was surgical, by trans-sphenoidal or transcranial approach depending on the tumour extent, followed by radiotherapy if necessary. In spite of modern investigation methods, diagnosis is still often made late, so that 118 of our cases already had visual symptoms. After surgery alone (87 cases) made by the same team recurrences occurred in 16%. Reoperations (14 cases) were generally more difficult and could also be followed by new recurrences needing finally radiotherapy with still positive results. Two cases had initial radiotherapy, the other 46 cases were treated by surgery and radiotherapy with a recurrence level of 8.3%. These results indicate the need to use immediate postoperative radiotherapy in every pituitary adenoma showing even the slightest invasive potential because radical surgery is hypothetical and recurrences possible. The recurrence of pituitary adenomas remains a difficult problem of anticipation and of curative management. Our position in terms of these benign tumours is to adopt readily this therapeutic course: surgery followed by radiotherapy, which provides the best prognosis without major risks.