Analysis Of The Related Factors Of The Therapeutic Efficacy Of Endonasal Transsphenoidal Ectomy Of Pituitary Adenoma

Objectives:Analysis the related factors of the therapeutic efficacy of endonasal transsphenoidal ectomy of pituitary adenoma, in order to improve the recognition of the efficacy of the approach and improve the cure rate and degrade the recurrence rate.Methods:A retrospective analysis of the clinical data and following-up outcome was performed on patients treated with endonasal transsphenoidal ectomy of pituitary adenomas at the neurosurgery department of First Affiliated Hospital of Shanxi Medical University from March 2007 to July 2009. The study population included 126 patients. Analysis the factors which possibly affect patients ' prognosis:tumor size, tumor invasion, cystic change or apoplexy, totally or partly resected, adjunct therapy after operation. The clinical data, therapeutic methods and Following-up outcome of these patients of pituitary adenomas were recorded and statistically analyzed with logistic regression model.Results:The tumor cure rate was 88.9%(112/126). Logistic regression analysis showed that the prognosis of the pituitary tumor after surgery was related to the size of the tumor, the invasion of adenomas, the resection range and the radiotherapy after operation All these factors showed significant difference(p<0.05).The size and the invasion of the adenomaβ<0 Exp((β)<1, demonstrated the factor may promote the risk of tumor recurrence; the resection range and radiotherapyβ>0 Exp(β)>1 demonstrated these two factors may reduce the risk of recurrence. According to the standard regression coefficient, the factor of the resection range played the most important role in reducing the recurrence rate of pituitary adenoma. The factor of the size non-invasion of adenomas was secondary and the factor of the non-invasion and radiotherapy after surgery was least. Other factors such as age, sex, cystic change and (or) apoplexy were unrelated to the prognosis of pituitary adenomas.Conclusion:The therapeutic efficacy is determinate in tumor size, tumor invasion, and excisional circumscription. The general assessment of preoperative invasive tumors and macro-adenomas, complete tumor removal as possible in operation and the adjunct postoperative therapy can elevate the cure rate and reduce the pituitary tumor recurrence.