Post-operative Outcomes of Pituitary Macroadenoma Patients in a Tertiary Hospital in the Philippines.

Background: Pituitary adenomas comprise approximately 20% of surgically resected intracranial tumors. This study aimed to collect local data on the post-operative neurologic, visual and endocrine outcomes of patients with pituitary macroadenoma. Methodology: This is a retrospective study of patients with pituitary macroadenoma who underwent neurosurgery at the Philippine General Hospital between 2017 to 2022. Data on demographics, clinical signs and symptoms, neuro-ophthalmologic examination findings, hormonal and radiologic studies, type of surgery, and post-operative outcomes were collected. Statistical analyses were done to compare the neurologic, ophthalmologic and endocrine status pre- and post-operatively. Results: A total of 122 patients were included. The mean age was 44.18 years, and majority (50.82%) were female. The most common presentation was blurring of vision. Most tumors were non-functioning (77.87%). Among the functioning adenomas, the most common was acromegaly. The median tumor size was 3.5 cm, and the median time to surgery was 18 months. Microscopic transsphenoidal surgery was the most common approach (60.83%) followed by endoscopic resection (24.17%). There was significant improvement in visual acuity post-operatively ( Conclusion: This is the first local study to comprehensively assess the entirety of post-operative outcomes among pituitary macroadenoma patients. Our results showed that even patients with longstanding visual and endocrine deficits may still improve with surgery.