ArticlePituitary2019
Predicting early post-operative remission in pituitary adenomas: evaluation of the modified knosp classification.
Article in Pituitary, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 2 of them syntheses that pooled it.
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Who cites it
27 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- DNA methylation as a predictor of pituitary neuroendocrine tumour behaviour: A systematic review.Journal of neuroendocrinology · 2026Pooled it
- Pooled it
- Long-term outcomes of adjuvant proton radiotherapy (PRT) for residual pituitary adenoma (PA) in adults - a retrospective, single institute experience.Journal of neuro-oncology · 2026Article
- Recurrent pituitary adenomas treated by endoscopic endonasal transsphenoidal surgery: The role of tumour extension and surgical feasibility.Brain & spine · 2026Article
- Anteroposterior suprasellar diameter as a predictor of gross total resection in pituitary adenomas with suprasellar extension: A retrospective cohort study.Surgical neurology international · 2026Article
- From Subtle Signs to Severe Sequelae-A Century of Symptomatology and Comorbidities in the Diagnosis of GH-Secreting Pituitary Neuroendocrine Tumors: A Systematic Review.Diagnostics (Basel, Switzerland) · 2025Review
- Predictors of residual and recurrent pituitary neuroendocrine tumors: impact of medial cavernous sinus wall invasion and Trouillas grading.Neuroradiology · 2025Article
- Specific focus on the basal dura for improving Cushing's disease surgery: a cohort study.Neurosurgical review · 2025Article
- The periphery of pituitary macroadenoma expressed higher invasive capability: the importance of clinical implication.Discover oncology · 2025Article
- Flow cytometry immune profiling of recurrent and newly diagnosed growth hormone secreting pituitary neuroendocrine tumors: comparison of two clinical cases.BMC endocrine disorders · 2025Article
- Grading and staging for pituitary neuroendocrine tumors.Brain pathology (Zurich, Switzerland) · 2025Review
- Fluorescence detection of pituitary neuroendocrine tumour during endoscopic transsphenoidal surgery using bevacizumab-800CW: a non-randomised, non-blinded, single centre feasibility and dose finding trial [DEPARTURE trial].European journal of nuclear medicine and molecular imaging · 2025Article
- Knosp and revised Knosp classifications predict non-functioning pituitary adenoma outcomes: a single tertiary center experience.Journal of medicine and life · 2024Article
- Risk factor analysis and prediction model to establish recurrence or progression of non-functioning pituitary adenomas in men after transnasal sphenoidal surgery.Scientific reports · 2024Article
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- Article
- Supervised machine learning to validate a novel scoring system for the prediction of disease remission of functional pituitary adenomas following transsphenoidal surgery.Scientific reports · 2023Article
- Prognostic Models in Growth-Hormone- and Prolactin-Secreting Pituitary Neuroendocrine Tumors: A Systematic Review.Diagnostics (Basel, Switzerland) · 2023Review
- Article
- Application of Convolutional Neural Network in the Diagnosis of Cavernous Sinus Invasion in Pituitary Adenoma.Frontiers in oncology · 2022Article
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeCavernous sinus invasion by pituitary adenomas is an important prognostic factor for evaluating the possibilities of complete remission and to guide patient management. A widely used Magnetic Resonance Imaging grading system, suggested by Knosp in 1993, has recently been revised by the same group. The aims of our study were to apply this revised grading system to our surgical series, to determine its association with surgical outcomes, gross-total resection (GTR) and endocrinological remission (ER), paying particular attention to grades 3A and 3B, which represent the novelty of this revised classification.
methodsWe included consecutive patients who underwent endoscopic endonasal surgery for a macroadenoma from September 2012 to December 2016. MRI images were reviewed and classified according to the revised Knosp classification. Surgical reports indicated the intra-operative CS invasion. GTR and ER were evaluated on 3-months post-operative MRI and endocrine evaluation.
results254 patients were included in this study. We found a total rate of cavernous sinus invasion of 18.4%. Different outcomes were observed for each grade, with an increased rate of cavernous sinus invasion with each grade. Per-operative rates of invasion were 61.5 and 78.6% in grades 3A and 3B respectively. GTR was negatively correlated with the grade, while rates were 55.8% and 30.0% for grades 3A and 3B respectively.
conclusionThe revised Knosp radiological classification contributes to the prediction of surgical outcomes and early ER in pituitary adenomas. To manage, as precisely as possible, the risk of early recurrence in pituitary adenomas, clinicians should also consider other recognized prognostic factors, such as the proliferative status of the tumor.
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