ArticleEndocrine2022
Effect of pituitary adenoma consistency on surgical outcomes in patients undergoing endonasal endoscopic transsphenoidal surgery.
Article in Endocrine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Machine learning-based models for preoperative prediction of pituitary adenoma consistency: a systematic review and meta-analysis.Acta neurochirurgica · 2026Pooled it
- Preoperative Prediction of Pituitary Adenoma Consistency Using Synthetic MRI and Virtual Magnetic Resonance Elastography.Journal of magnetic resonance imaging : JMRI · 2026Article
- Radiomics and artificial intelligence in pituitary adenomas (PitNETs): from imaging biomarkers to clinical translation.Reviews in endocrine & metabolic disorders · 2026Review
- Article
- Machine Learning Prediction of Pituitary Macroadenoma Consistency: Utilizing Demographic Data and Brain MRI Parameters.Journal of imaging informatics in medicine · 2025Article
- Challenges and opportunities for new intraoperative optical techniques in the surgical treatment of pituitary adenomas: a review.Journal of biomedical optics · 2025Review
- A single-center prospective study evaluating the relationship of tumor consistency on remission in acromegaly patients.Scientific reports · 2025Article
- Article
- Letter to the Editor Regarding "The Effect of Preoperative Cabergoline on Prolactinoma Fibrosis: A Case Series".Journal of neurological surgery reports · 2024Article
- Multi-Dynamic-Multi-Echo-based MRI for the Pre-Surgical Determination of Sellar Tumor Consistency: a Quantitative Approach for Predicting Lesion Resectability.Clinical neuroradiology · 2024Article
- Clinical presentation and surgical outcomes of very large and giant pituitary adenomas: 80 cases in a cohort study of 306 patients with pituitary adenomas.Acta neurochirurgica · 2024Article
- Development and validation of a prediction model for consistency of pituitary adenoma: the PiTCon score.Acta neurochirurgica · 2024Article
- The current state of MRI-based radiomics in pituitary adenoma: promising but challenging.Frontiers in endocrinology · 2024Review
- Pituitary adenoma consistency affects postoperative hormone function: a retrospective study.BMC endocrine disorders · 2023Article
- Pituitary macroadenoma: less common neuroimaging features in a common lesion.Radiologia brasileiraArticle
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Authors and funding
5 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundMost pituitary adenomas (PAs) are considered to have a soft tumor consistency. However, there is a non-negligible percentage (5-13%) of tumors presenting or exhibiting a fibrous consistency that would entail a more difficult and complicated surgical excision with higher surgical morbidity and mortality rates. PURPOSE: To analyze the clinical consequences of PA tumor consistency on the surgical outcomes in patients undergoing endonasal endoscopic transsphenoidal (EET) pituitary surgery.
methodsAn ambispective study of patients with PAs operated on through an EET approach in two Spanish tertiary hospitals over the last 12 years. A total of 226 consecutive interventions were carried out in the Neurosurgery Departments of the Hospital Universitario Ramón y Cajal (HURC) and the Hospital Universitario Puerta del Sur by the same neurosurgeon. PAs were grouped into soft (n = 150) and fibrous (n = 76). All patients underwent hormonal and magnetic resonance imaging (MRI) studies before and after surgery. In addition, neurosurgical complications were recorded in each patient.
resultsFibrous adenomas were independently associated with lower resection rates compared to soft adenomas (fibrous gross total resection [GTR] rate 48.7% vs. 76.3%, p < 0.001), even in those adenomas without invasion of the cavernous sinus (Knosp grades 0, I, and II). There were more intraoperative cerebrospinal fluid (CSF) leaks in patients with fibrous PAs. Moreover, fibrous PAs showed higher rates of postoperative hypopituitarism, permanent diabetes insipidus (DI) and postoperative treatments (hormonal treatment and radiotherapy). The excision of a fibrous PA required a longer surgical time (22.5 min more than soft PAs, p = 0.014), regardless of other factors.
conclusionThe consistency of the PAs significantly conditions both the results of surgery (lower resections rates), complications (higher incidence of postoperative hypopituitarism, permanent DI), and the prognosis (higher incidence of postoperative treatments) of the patient undergoing EET.
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