[Does selectivity in radical adenomectomy in invasive hypophyseal adenomas increase the risk of recurrence?]

Between 1989 and 1992 we operated 52 patients primarily due to pituitary adenoma. The tumor growths were evaluated microsurgically or histologically as invasive in 29 of them. Radical adenomectomy was achieved in 65.5% of patients with invasive and in 91.3% of patients with noninvasive pituitary adenoma--in 40 cases altogether. Although it was possible to identify and preserve pituitary tissue remnants in 23 cases, the real selectivity, confirmed by biochemical testing, was finally achieved only in 16 of them. Only one recurrence, 8 months after the radical nonselective removal of nonfunctional extrasellar invasive adenoma occurred during the median follow-up time of 2.61 years (minimal follow-up time 1 year). We have found out no significant differences in the recurrence rates between invasive and noninvasive pituitary adenomas after their radical selective and nonselective removal. We suppose that nonselective radical adenomectomy is not necessary to prevent the recurrence of the invasive pituitary adenoma. (Tab. 7, Ref. 15.)