Abstract :
Pituitary adenomas, benign intracranial tumors with an incidence of 4-7 per 100,000 annually, are categorized into non-functioning (NFPA) and functioning pituitary adenomas (FPA). Despite surgery being the primary treatment, recurrence remains a significant challenge, with rates of 53% at 5 years and up to 80% at 10 years for incomplete resections. This systematic review evaluates factors associated with postoperative recurrence to enhance understanding and improve outcomes. A literature search was conducted in PubMed and ScienceDirect, covering studies from the past 15 years up to August 8, 2024. Inclusion criteria were patients aged >18 years who underwent pituitary adenoma resection, with at least one year of follow-up and involving 30 or more subjects. Studies with repeated surgeries and non-English articles were excluded. Keywords included ("pituitary" OR "hypophys*") AND ("tumo*" OR "adenoma") AND "recur*" AND "factor*". Quality assessment used the Newcastle-Ottawa Scale. From 7,322 articles, eleven studies met the criteria, totaling 2,814 subjects. These studies varied in design, including retrospective and cohort studies, focusing on both NFPA and FPA. Key findings highlight that tumor size, invasiveness, hormonal activity, and extent of resection significantly influence recurrence. Larger tumors and those with cavernous sinus invasion present higher recurrence risks. Molecular markers like Ki-67 and p53, along with surgical factors, are crucial in predicting recurrence. This review identifies key factors associated with pituitary adenoma recurrence post-surgery. Incorporating these into clinical practice may aid in developing personalized management plans and improving outcomes. Further research is needed to refine predictive models and strategies for long-term disease control.
