Fédération d'Endocrinologie, Centre de Référence Maladies Rares Hypophysaires HYPO, Groupement Hospitalier Est, Hospices Civils de Lyon, Hôpital Louis Pradel-1er étage, 59 Bd Pinel, 69677, Bron Cedex, France.
Faculté de Médecine Lyon Est, Université Lyon 1, 69372, Lyon, France.
Pituitary. 2018 Apr;21(2):176-182. doi: 10.1007/s11102-017-0861-3.
Surgery is the treatment of choice for nonfunctioning pituitary tumors (NFPTs). Postoperative tumor regrowth during follow-up is present in about half of the patients with invasive NFPTs with residual tumor but occurs also in 15% of patient without residue. Therapeutic strategies should consider this risk of recurrence and the potential side effects associated with therapeutic options. Identification of prognostic markers is mandatory to help clinicians to predict the risk of recurrence and to choose the best strategy between conservative follow-up, second surgery, postoperative adjuvant radiation therapy, and medical treatment (dopamine agonists, somatostatin analogs). Recent advances in pathological classification may be the first step for identification of NFPTs with a high risk of recurrence.
手术是治疗无功能垂体瘤（NFPTs）的首选方法。在随访期间，大约一半的侵袭性 NFPTs 患者存在残留肿瘤的术后肿瘤复发，但也有 15%的患者没有残留肿瘤。治疗策略应考虑到这种复发风险以及与治疗选择相关的潜在副作用。确定预后标志物是强制性的，以帮助临床医生预测复发风险，并在保守随访、二次手术、术后辅助放疗和药物治疗（多巴胺激动剂、生长抑素类似物）之间选择最佳策略。病理分类的最新进展可能是识别复发风险高的 NFPTs 的第一步。
