P.096 Practice patterns in the management of residual/recurrent non-functioning pituitary adenomas: results from a Canada-wide survey

Abstract

Background: Postoperative follow-up of non-functioning pituitary adenomas (NFAs) occasionally detects residual or recurrent disease. Subsequent treatment options range from continued follow-up, to re-resection or radiotherapy. To better understand current practice patterns on this topic, we surveyed neurosurgeons and radiation oncologists in Canada. Methods: Skull-base neurosurgeons and radiation oncologists across Canada were invited to complete a 25-item online questionnaire. Summary statistics were computed and 2-tailed t-tests were performed to assess significance. Results: 33 participants returned completed questionnaires: neurosurgeons (n=20, 61%) and radiation oncologists (ROs; n=13, 39%). When treating giant (>3cm) tumours, 92% of neurosurgeons in practice for less than 15 years use an endoscopic approach, as compared to only 57% of neurosurgeons in practice for 15 years or more. Additionally, younger neurosurgeons have a greater tendency to advocate for stereotactic radiosurgery (SRS) or re-resection (54% and 38%, respectively), as compared to older surgeons who show a higher propensity (29%) to advocate for observation. The presence of cavernous sinus extension appears to encourage neurosurgeons (40%) to offer radiotherapy sooner, as compared to 62% of ROs. Conclusions: Our results identify both variations and commonalities in practice amongst Canadian neurosurgeons. Approaches deviate in the setting of residual tumors based on years of practice.