ArticleJournal of endocrinological investigation2021
Predictive model of surgical remission in acromegaly: age, presurgical GH levels and Knosp grade as the best predictors of surgical remission.
Article in Journal of endocrinological investigation, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 1 of them a synthesis that pooled it.
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Who cites it
26 citing papers in PubMed, 1 synthesis or guideline pooled it, 48 citations in OpenAlex.
- The effect of endoscopic transsphenoidal somatotroph tumors resection on pituitary hormones: systematic review and meta-analysis.World journal of surgical oncology · 2023Pooled it
- Endoscopic endonasal transcavernous surgery for knosp grade 3-4 growth hormone-secreting pituitary neuroendocrine tumors: surgical outcomes and predictors of biochemical remission.Neurosurgical review · 2026Article
- Pituitary adenoma imaging as a determinant of acromegaly diagnosis and outcomes.The Journal of clinical endocrinology and metabolism · 2026Review
- Histopathological and radiological predictors of surgical remission failure in GH-secreting pituitary adenomas.Pituitary · 2026Review
- Early Postoperative Predictors of Remission After Transsphenoidal Surgery in Acromegaly: Introduction of the PARS.Journal of the Endocrine Society · 2026Article
- Risk factor identification and nomogram-based predictive model development for recurrence of pituitary adenomas following transsphenoidal surgery: a dual-center retrospective study.Frontiers in surgery · 2026Article
- Outcome of acromegalic patients undergoing endoscopic endonasal surgery: collaborative French and Italian cohort, a 25-year experience.Neurosurgical review · 2025Article
- Challenges and opportunities for new intraoperative optical techniques in the surgical treatment of pituitary adenomas: a review.Journal of biomedical optics · 2025Review
- Gross total resection in low-grade and pretreated high-grade invasive growth hormone pituitary adenomas promises favorable outcomes.Discover oncology · 2025Article
- Predictors of therapeutic failure in GH and prolactin co-secreting pituitary adenomas.Endocrine connections · 2025Article
- Is Knosp enough? A novel classification for Acromegaly: a retrospective analysis of cure rates and outcome predictors in a large tertiary centre.Acta neurochirurgica · 2025Article
- Preoperative medical therapy for acromegaly: current knowledge and clinical significance.Frontiers in endocrinology · 2025Review
- 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
- Clinico-radio-pathological predictors of outcomes in patients with acromegaly undergoing endoscopic transsphenoidal surgery.Surgical neurology international · 2024Article
- Fully automated imaging protocol independent system for pituitary adenoma segmentation: a convolutional neural network-based model on sparsely annotated MRI.Neurosurgical review · 2023Article
- Preoperative medical treatments and surgical approaches for acromegaly: A systematic review.Clinical endocrinology · 2023Review
- Preoperative and postoperative blood testosterone levels in patients with acromegaly: a prospective study.Frontiers in endocrinology · 2023Article
- Multidisciplinary management of difficult/aggressive growth-hormone pituitary neuro-endocrine tumors.Frontiers in endocrinology · 2023Review
- Effect of pituitary adenoma consistency on surgical outcomes in patients undergoing endonasal endoscopic transsphenoidal surgery.Endocrine · 2022Article
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Authors and funding
8 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo identify presurgical clinical, hormonal and radiological variables associated with surgical remission in acromegaly and develop a predictive model for surgical remission.
methodsAmbispective study of acromegaly surgical patients followed in two Spanish tertiary hospitals. Patients operated by the same neurosurgeon by endonasal endoscopic transsphenoidal approach (n = 49) were included to develop the predictive model, and patients operated by other neurosurgeons (n = 37) were used for external validation of the predictive model. The predictive model was developed with a multivariate logistic regression model based on the 2000 criteria.
results86 acromegalic patients were included. 49 patients, 83.7% with macroadenomas and 32.7% with Knosp grade > 2, were included for the development of the predictive model. The overall rate of surgical remission with the 2000 criteria was 73.5% and 51.0% with the 2010 criteria. Using the 2000 criteria, variables associated with surgical remission were: older age (OR = 1.1, p = 0.001), lower basal presurgical GH levels (OR = 0.9, p = 0.003), Knosp 0-2 (OR = 34.1, p < 0.0001) and lower maximum pituitary adenoma diameter (OR = 0.9, p = 0.019). The model with the best diagnostic accuracy to predict surgical remission combined age, Knosp 0-2 and presurgical GH levels (AIC = 29.7, AUC = 0.95) with a sensitivity of 93.8% and a specificity of 75.0%. The estimated loss of prediction with the external validation (n = 37) was 4.2%.
conclusionThe predictive model with the best diagnosis accuracy for surgical remission combined age, Knosp 0-2 and presurgical GH levels, with a sensitivity of 93.8% and a specificity of 75.0%. This model could be very useful to select candidates to preoperative medical treatment and planning the follow-up.
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