The clinical characteristics and microsurgical therapy of pituitary adenomas in elderly patients: A retrospective study of 130 cases.

OBJECTIVE: To investigate the clinical characteristics and microsurgical therapy of pituitary adenomas in elderly patients.

METHOD: This article describes a retrospective study of 130 pituitary adenomas in elderly patients over 65years of age who underwent a microsurgical operation using the transsphenoidal approach and were admitted to Peking Union Medical College Hospital (PUMCH) from January 2010 to December 2012.

RESULTS: A total of 60 (46.2%) males and 70 females (53.8%) were included, and the mean age of the patients was 68.38years. The main clinical manifestation was visual defects (35.4%), and the levels of growth hormone (GH), insulin-like growth factor-1 (IGF-1), adrenocorticotropic hormone (ACTH), and prolactin (PRL) were increased by 11.5%, 11.5%, 6.2%, and 7.7%, respectively. All patients underwent the transsphenoidal approach. The main comorbidity prior to surgery was hypertension (45.0%), and the average duration of follow-up was 39.6±10.6months. Tumor recurrence was observed in 19 patients, 17 of which received radiological therapy, and two patients underwent an additional operation at our hospital. The rate of loss to follow-up was 15.9%.

CONCLUSION: There was no significant difference in the surgical outcome, mortality in the perioperative period or complications between the elderly patients and the general population. However, the indications for pituitary adenomas in elderly patients still require further age-specific guidelines.