Evidence map›Paper›PMID 36862265›Full record

SynthesisPituitary2023

Reported outcomes in transsphenoidal surgery for pituitary adenomas: a systematic review.

Hugo Layard Horsfall, Alistair Lawrence, Ashwin Venkatesh, Ryan T S Loh, Ronie Jayapalan, Olympia Koulouri, Rishi Sharma, Thomas Santarius, Mark Gurnell, Neil Dorward and 3 more

Abstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Pituitary, 2023. 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.

0numbers the graph read from it
0cells of the map it votes in
15citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

15 citing papers in PubMed, 1 synthesis or guideline pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Hugo Layard HorsfallDivision of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK. hugo.layardhorsfall@ucl.ac.uk.
Alistair LawrenceDepartment of Neurosurgery, Royal London Hospital, London, UK.
Ashwin VenkateshClinical School of Medicine, University of Cambridge, Cambridge, UK.
Ryan T S LohClinical School of Medicine, University of Cambridge, Cambridge, UK.
Ronie JayapalanDivision of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK.
Olympia KoulouriMetabolic Research Laboratories, Institute of Metabolic Science and Department of Medicine, University of Cambridge and Addenbrooke's Hospital, Cambridge, UK.
Rishi SharmaDepartment of Otolaryngology, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK.
Thomas SantariusDivision of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK.
Mark GurnellMetabolic Research Laboratories, Institute of Metabolic Science and Department of Medicine, University of Cambridge and Addenbrooke's Hospital, Cambridge, UK.
Neil DorwardDepartment of Neurosurgery, The National Hospital for Neurology and Neurosurgery, Queen Square, London, W1CN 3BG, UK.
Richard MannionDivision of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK.
Hani J MarcusDepartment of Neurosurgery, The National Hospital for Neurology and Neurosurgery, Queen Square, London, W1CN 3BG, UK.
Angelos G KoliasDivision of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital and University of Cambridge, Cambridge, UK.

Funding

Wellcome / EPSRC Centre for Interventional and Surgical Sciences NS/A000050/1Wellcome Trust
6 · The paper itself

Abstract

purposeTranssphenoidal surgery is an established treatment for pituitary adenomas. We examined outcomes and time points following transsphenoidal surgery for pituitary adenoma to identify reporting heterogeneity within the literature.

methodsA systematic review of studies that reported outcomes for transsphenoidal surgery for pituitary adenoma 1990-2021 were examined. The protocol was registered a priori and adhered to the PRISMA statement. Studies in English with > 10 patients (prospective) or > 500 patients (retrospective) were included.

results178 studies comprising 427,659 patients were included. 91 studies reported 2 or more adenoma pathologies within the same study; 53 studies reported a single pathology. The most common adenomas reported were growth hormone-secreting (n = 106), non-functioning (n = 101), and ACTH-secreting (n = 95); 27 studies did not state a pathology. Surgical complications were the most reported outcome (n = 116, 65%). Other domains included endocrine (n = 104, 58%), extent of resection (n = 81, 46%), ophthalmic (n = 66, 37%), recurrence (n = 49, 28%), quality of life (n = 25, 19%); and nasal (n = 18, 10%). Defined follow up time points were most reported for endocrine (n = 56, 31%), extent of resection (n = 39, 22%), and recurrence (n = 28, 17%). There was heterogeneity in the follow up reported for all outcomes at different time points: discharge (n = 9), < 30 days (n = 23), < 6 months (n = 64), < 1 year (n = 23), and > 1 year (n = 69).

conclusionOutcomes and follow up reported for transsphenoidal surgical resection of pituitary adenoma are heterogenous over the last 30 years. This study highlights the necessity to develop a robust, consensus-based, minimum, core outcome set. The next step is to develop a Delphi survey of essential outcomes, followed by a consensus meeting of interdisciplinary experts. Patient representatives should also be included. An agreed core outcome set will enable homogeneous reporting and meaningful research synthesis, ultimately improving patient care.

Indexed as

AdenomaPituitary NeoplasmsHumansPatient Reported Outcome MeasuresProspective StudiesQuality of LifeRetrospective StudiesTreatment OutcomeAdenomaCore outcome setsNeurosurgeryOutcomePituitaryTranssphenoidal

Identifiers

PMID36862265
PMCPMC10247847

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.