TABLE 6.
Clinical and secretory hormone outcomes
| Outcome | Total Cohort, n = 212* | Microscopic Only, n = 130 | Endoscopic Only, n = 75 |
|---|---|---|---|
| VF deficit | 81 | 53 | 25 |
| Improved/resolved | 80 (99) | 52 (98) | 25 (100) |
| Stable | 1 (1) | 1 (2) | 0 (0) |
| Secretory adenoma | 72 (34) | 42 (32) | 27 (36) |
| Initial hormone remission† | 46/72 (64) | 23/42 (55) | 22/27 (81) |
| GH | 19/29 (66) | 10/17 (59) | 9/11 (82) |
| ACTH | 16/20 (80) | 7/9 (78) | 8/10 (80) |
| PRL | 11/23 (48) | 6/16 (38) | 5/6 (83) |
| Recurrence after remission | 11/46 (24) | 7/23 (30) | 4/22 (18) |
| Median (95% CI) RFS in mos | 81.6 (47.6–100.2) | 81.6 (47.6–100.2) | Not reached |
| Further treatment of secretory adenoma‡ | 35 (49) | 24 (57) | 9 (33) |
| Medical only | 23 (32) | 16 (38) | 6 (22) |
| RT | 2 (3) | 0 (0) | 2 (7) |
| Med + RT | 4 (6) | 3 (7) | 1 (4) |
| Surgery | 0 (0) | 0 (0) | 0 |
| Med + surgery | 5 (7) | 4 (10) | 0 |
| Med + surgery + RT | 1 (1) | 1 (2) | 0 |
| Hormone remission at last FU‡ | 54 (75) | 30 (71) | 22 (81) |
| Hormone remission at last FU off medication‡ | 43 (60) | 23 (55) | 19 (70) |
| Preop hormone deficit improved/resolved | |||
| None | 35/64 (55) | 23/34 (68) | 9/26 (35) |
| 1 or more | 29/64 (45) | 11/34 (32) | 17/26 (65) |
| Preop deficit improvement by type | |||
| Hypocortisolemia | 7/23 (30) | 4/15 (27) | 3/7 (43) |
| Hypogonadism | 20/50 (40) | 6/27 (22) | 8/12 (67) |
| Hypothyroidism | 14/31 (45) | 6/18 (33) | 13/20 (65) |
| GH deficiency | 2/5 (40) | 1/4 (25) | 1/1 (100) |
Clinical outcomes were evaluated based on treatment group. VF deficits improved or resolved in 99% of patients, including 100% of patients treated via ETS. Hormone remission was defined as return to normal hormone levels off of medical therapy. No patients treated via ETS required further surgery for secretory tumor hormone secretion. ETS resulted in higher rates of hormone remission than MTS (p = 0.02). Preoperative hormone deficits were evaluated for lack of improvement or resolution of ≥ 1 preoperative deficit. Preoperative deficits were improved in 65% of patients treated via ETS. Unless otherwise indicated, values are expressed as the number of patients (%).
This includes 7 patients treated via a combined MTS and ETS approach.
Hormone remission defined off medical therapy, without any additional treatment.
Hormone remission on or off medication, total cohort 72 secretory tumors.