ArticleJournal of clinical medicine2022
Classifying Pituitary Adenoma Invasiveness Based on Radiological, Surgical and Histological Features: A Retrospective Assessment of 903 Cases.
Article in Journal of clinical medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
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Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The effect of endoscopic transsphenoidal somatotroph tumors resection on pituitary hormones: systematic review and meta-analysis.World journal of surgical oncology · 2023Pooled it
- Postoperative Pituitary MRI Findings in Acromegaly: A Pictorial Review.Diagnostics (Basel, Switzerland) · 2026Review
- Invasiveness, SOX2 Expression, and Resection Outcomes in TF-Defined PitNETs After Extra-Pseudocapsular Resection.Current medical science · 2026Article
- Elevated IgG levels induce an M2‑to‑M1 phenotypic shift in mucosal macrophages and restrict the growth of invasive sphenoid sinus pituitary adenomas.Molecular medicine reports · 2026Article
- MRI radiomics-based approach to predict pituitary neuroendocrine tumor invasiveness.European radiology experimental · 2026Article
- A Retrospective cohort study of Knosp grade reporting of cavernous sinus invasion in pituitary macroadenomas.Pituitary · 2026Article
- The PKA/MBD2 Axis Transcriptionally Represses INPP5A to Modulate PI3K/Akt Signaling and Accelerate Pituitary Tumorigenesis.CNS neuroscience & therapeutics · 2026Article
- Article
- A Clival Mass Posing a Diagnostic Challenge: Pituitary Adenoma With Rathke Cleft Cyst Mimicking Chordoma.Cureus · 2026Article
- Management of Recurrent and Aggressive Non-Functioning Pituitary Adenomas.Journal of clinical medicine · 2025Review
- Molecular signatures of invasive and non-invasive pituitary adenomas: a comprehensive analysis of DNA methylation and gene expression.BMC medicine · 2025Article
- [Pattern of invasive growth of pituitary adenomas with positive hormonal immunohistochemistry].Revista medica del Instituto Mexicano del Seguro Social · 2025Observational
- Article
- Trouillas's Grading and Post-Surgical Tumor Residue Assessment in Pituitary Adenomas: The Importance of the Multidisciplinary Approach.Diagnostics (Basel, Switzerland) · 2024Article
- The miR-19a/Cylindromatosis Axis Regulates Pituitary Adenoma Bone Invasion by Promoting Osteoclast Differentiation.Cancers · 2024Article
- A disintegrin and metalloproteinase 22 activates integrin β1 through its disintegrin domain to promote the progression of pituitary adenoma.Neuro-oncology · 2024Article
- Adaptive evaluation of gross total resection rates for endoscopic endonasal approach based on preoperative MRI morphological features of pituitary adenomas.Frontiers in oncology · 2024Article
- Article
- Markers of Aggressiveness in Pituitary Tumors: Update and Perspectives.Journal of clinical medicine · 2022Article
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Authors and funding
6 authors.
Funding
Abstract
Invasiveness is a major predictor of surgical outcome and long-term prognosis in patients with pituitary adenomas (PAs). We assessed PA invasiveness via radiological, surgical and histological perspectives to establish a classification scheme for predicting invasive behavior and poor prognosis. We retrospectively analyzed 903 patients who underwent transnasal-transsphenoidal surgery between January 2013 and December 2019. Radiological (hazard ratio (HR) 5.11, 95% confidence interval (CI): 3.98−6.57, p < 0.001) and surgical (HR 6.40, 95% CI: 5.09−8.06, p < 0.001) invasiveness better predicted gross-total resection (GTR) and recurrence/progression-free survival (RPFS) rates than did histological invasiveness (HR 1.44, 95% CI: 1.14−1.81, p = 0.003). Knosp grades 2 (HR 4.63, 95% CI: 2.13−10.06, p < 0.001) and 3 (HR 2.23, 95% CI: 1.39−3.59, p = 0.011) with surgical invasiveness were better predictors of prognosis than corresponding Knosp grades without surgical invasiveness. Classifications 1 and 2 were established based on radiological, surgical and histological invasiveness, and Knosp classification and surgical invasiveness, respectively. Classification 2 predicted RPFS better than Knosp classification and Classification 1. Overall, radiological and surgical invasiveness were clinically valuable as prognostic predictors. The convenience and good accuracy of Invasiveness in Classification 2 is useful for identifying invasive PAs and facilitating the development of treatment plans.
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