P.168 Prediction of Pituitary Adenoma Recurrence using the SIPAP Classification

Abstract

Background: Pituitary tumor recurrence following endoscopic endonasal transsphenoidal surgery (EETS) has been reported widely. We evaluated a modified score using the SIPAP classification system, combining the suprasellar and paraseller extension scores of the pituitary tumor, to determine its impact on adenoma recurrence. Methods: A retrospective cohort study design with patient characteristics, tumor type, endocrine, operation, imaging data collected. Preoperative MRI images were reviewed and SIPAP classification applied. Postoperative data were extracted for the follow-up period available for each patient.The suprasellar score and the highest parasellar scoring from both sides were numerically summed in a bilateral suprasellar and parasellar (SaP) score and combined to make 4 grades. Results: 276 patients were identified, 56.5% of the cohort was male. The mean cohort age was 54 years old.The mean follow up period was 32 months. Patient perioperative tumor grade according to SaP classification and recurrence rate was: Grade 1: 11%: Grade 2: 10%; Grade 3: 15%; Grade 4: 22%. The results followed a pattern of logarithmic curve. Conclusions: The SaP classification was useful in determining the pituitary tumor expected recurrence following EETS. The advanced tumors had the highest recurrence rates. Use of the SaP score may allow for more accurate preoperative counselling of patients with pituitary adenoma.