Importance of a Multidisciplinary Team Approach for Optimizing Pituitary Surgery Outcomes

Pituitary tumors including pituitary adenomas and related lesions such as craniopharyngiomas and Rathke’s cleft cysts present with a wide range of hormonal and neurological signs and symptoms resulting in a variety of referral pathways. A multidisciplinary approach to the diagnostic evaluation and treatment plan is essential to optimise outcomes. The patient is seen by each member of the team, including neurosurgeon, endocrinologist, head & neck surgeon, nurse practitioner and in some instances neuro-ophthalmologist, oncologist, radiation oncologist and interventional neuroradiologist. Appropriate investigations are undertaken and a further meeting arranged at which all opinions are discussed. A reasoned treatment regimen is recommended, taking into consideration the patient’s wishes and overall medical condition. This manuscript describes the team approach currently employed in the Brain Tumor Center and Pituitary Disorders Program at Providence Saint John’s Health Center & John Wayne Cancer Institute. When referring pituitary patients to this centre, health care professionals and patients alike are experiencing the positive benefits received from a patient-centred, multidisciplinary approach.