Evidence map›Paper›PMID 40442537›Full record

ArticlePituitary2025

Outcomes of stereotactic radiosurgery for pituitary metastases: an international multi-institutional study.

Hussam Abou-Al-Shaar, Ibrahem Albalkhi, Rimsha K Shariff, Arka N Mallela, Pouneh K Fazeli, Salem M Tos, Georgios Mantziaris, Ying Meng, Kenneth Bernstein, Tehila Kaisman-Elbaz and 25 more

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in Pituitary, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing 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

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

  1. Pooled it
  2. Article
  3. Article
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

35 authors.

Hussam Abou-Al-ShaarDepartment of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA. aboualshaarh@upmc.edu.
Ibrahem AlbalkhiDepartment of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Rimsha K ShariffDivision of Endocrinology, Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Arka N MallelaDepartment of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Pouneh K FazeliDivision of Endocrinology, Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Salem M TosDepartment of Neurological Surgery, University of Virginia, Charlottesville, VA, USA.
Georgios MantziarisDepartment of Neurological Surgery, University of Virginia, Charlottesville, VA, USA.
Ying MengDepartment of Neurosurgery, NYU Langone Medical Center, New York University, New York, USA.
Kenneth BernsteinDepartment of Radiation Oncology, NYU Langone Medical Center, New York University, New York, USA.
Tehila Kaisman-ElbazDepartment of Neurosurgery, Sheba Medical Center, Ramat Gan, Israel.
Hanan AbofaniDepartment of Neurosurgery, Sheba Medical Center, Ramat Gan, Israel.
Yen-Yu LinDepartment of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.
Cheng-Chia LeeDepartment of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.
Manjul TripathiDepartment of Neurosurgery, PGIMER, Chandigarh, India.
Rituraj UpadhyayRadiation Oncology, The James Cancer Center, Ohio State University, Columbus, OH, USA.
Joshua D PalmerRadiation Oncology, The James Cancer Center, Ohio State University, Columbus, OH, USA.
Ahmed M NabeelGamma Knife Centre - Nasser Institute, Cairo, Egypt.
Wael A RedaGamma Knife Centre - Nasser Institute, Cairo, Egypt.
Sameh R TawadrosGamma Knife Centre - Nasser Institute, Cairo, Egypt.
Khaled AbdelkarimGamma Knife Centre - Nasser Institute, Cairo, Egypt.
Amr M N El-ShehabyGamma Knife Centre - Nasser Institute, Cairo, Egypt.
Reem M EmadGamma Knife Centre - Nasser Institute, Cairo, Egypt.
Selcuk PekerDepartment of Neurosurgery, Koc University School of Medicine, Istanbul, Turkey.
Yavuz SamanciDepartment of Neurosurgery, Koc University School of Medicine, Istanbul, Turkey.
Rodney E WegnerDepartment of Radiation Oncology, Allegheny Health Network Cancer Institute, Pittsburgh, PA, USA.
Matthew J ShepardDepartment of Neurosurgery, Allegheny Health Network Cancer Institute, Pittsburgh, PA, USA.
Roman LiscakDepartment of Stereotactic and Radiation Neurosurgery, Na Homolce Hospital, Prague, Czechia, Czechia.
Gabriela SimonovaStereotactic and Functional Neurosurgery, University of British Columbia, Vancouver, Canada.
Timoteo AlmeidaStereotactic and Functional Neurosurgery, University of British Columbia, Vancouver, Canada.
Carolina BenjaminDepartment of Neurosurgery, University of Miami Health System, Miami, FL, USA.
Douglas KondziolkaDepartment of Neurosurgery, NYU Langone Medical Center, New York University, New York, USA.
Jason P SheehanDepartment of Neurological Surgery, University of Virginia, Charlottesville, VA, USA.
Ajay NiranjanDepartment of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Constantinos G HadjipanayisDepartment of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
L Dade LunsfordDepartment of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPituitary metastases (PM) account for 0.4% of all intracranial metastases and typically present with visual and endocrinological deficits. Stereotactic radiosurgery (SRS) has shown excellent tumor control and safety profile in the management of intracranial metastases. However, its role and safety in managing metastases to the pituitary gland are not well-characterized. This study aims to evaluate SRS outcomes and safety profile in the management of PM in a multicenter international cohort.

methodsThe authors retrospectively analyzed data from 63 patients with PM treated with SRS across 12 institutions, assessing clinical and radiological outcomes, including survival rates, tumor control, visual and endocrinological outcomes, and post-treatment complications.

resultsAmong 63 patients included in the study (median tumor volume: 1.5 cc), SRS demonstrated a local tumor control rate of 93.1% at 12 months. The median survival was 25.4 months and overall survival rates of 77.6%, 65.9%, and 55.1% at 6, 12, and 18 months, respectively. In multivariate analysis, a margin dose for PM > 10 Gy emerged as an independent predictor across progression-free survival (HR: 0.20, p < 0.01), distant metastasis-free survival (HR: 0.30, p = 0.01), and overall survival. (HR: 0.15, p < 0.01). Following SRS, most patients showed stable or improved visual function (n = 17/18). A small percentage of patients experienced complications: developed new visual deficits (n = 1/63), experienced new anterior pituitary hormone deficiency (n = 5/63), and developed arginine vasopressin (AVP)-deficiency post-treatment (n = 2/63).

conclusionSRS is an important modality in the management of PM, offering excellent local tumor control and survival outcomes with minimal morbidity. These findings support the incorporation of SRS into the multidisciplinary management for treating patients with PM.

Indexed as

Pituitary NeoplasmsRadiosurgeryAdultAgedAged, 80 and overFemaleHumansMaleMiddle AgedRetrospective StudiesTreatment OutcomeMetastasesPituitary neoplasms, hormonal outcomesProgression-Free survivalStereotactic radiosurgerySurvival analysisVision

Identifiers

PMID40442537

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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.