Evidence map›Paper›PMID 41699274›Full record

SynthesisNeurosurgical review2026

Surgically treated giant pituitary neuroendocrine tumors: systematic review and meta-analysis with institutional cohort.

Sara Antonietti, Pier Paolo Panciani, Alessandro Fiorindi, Vittorio Rampinelli, Francesco Doglietto, Marco Maria Fontanella, Edoardo Agosti

Abstract readSystematic ReviewMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Neurosurgical review, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

7 authors.

Sara AntoniettiDivision of Neurosurgery, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Piazza Spedali Civili 1, 25123, Brescia, Italy.
Pier Paolo PancianiDivision of Neurosurgery, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Piazza Spedali Civili 1, 25123, Brescia, Italy.
Alessandro FiorindiDivision of Neurosurgery, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Piazza Spedali Civili 1, 25123, Brescia, Italy.
Vittorio RampinelliUnit of Otorhinolaryngology, Head and Neck Surgery, Department of Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy.
Francesco DogliettoNeurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCSS, Rome, Italy.
Marco Maria FontanellaDivision of Neurosurgery, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Piazza Spedali Civili 1, 25123, Brescia, Italy.
Edoardo AgostiDivision of Neurosurgery, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Piazza Spedali Civili 1, 25123, Brescia, Italy. edoardo_agosti@libero.it.ORCID http://orcid.org/0000-0002-6463-5000

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThis study aims to compare endoscopic endonasal approaches (EEAs) and transcranial approaches (TCAs) for the surgical treatment of giant pituitary neuroendocrine tumors (GPitNETs).

methodsA systematic literature review was conducted using PubMed, Ovid MEDLINE, and Web of Science for studies on GPitNETs treated with EEA or TCA up to April 2025, following PRISMA guidelines. Meta-analysis was performed using random effects to estimate pooled event rates and heterogeneity. Risk of bias was assessed with the ROBINS-I tool. Additionally, a retrospective cohort of 20 patients was included, for a total of 1,052 patients across 21 studies. Seven studies were comparative.

resultsA total of 21 studies (2010–2024) met inclusion criteria, with 1,032 patients undergoing EEAs or TCAs for GPitNETs. Additionally, we included a retrospective cohort of 20 patients from our institution, for a total sample of 1,052. Meta-analysis was conducted on 7 comparative studies with a total of 273 patients. Visual improvement was significantly higher with EEA (OR 3.73; 95% CI: 1.44–9.64; p < 0.01). Gross total resection (GTR), progression rates and most postoperative complications, including cerebrospinal fluid (CSF) leak, infection, diabetes insipidus, and hypopituitarism (HP), showed no significant differences. However, intracranial hemorrhage (ICH) was more frequent with TCAs (OR 0.09; 95% CI: 0.02–0.45; p < 0.01). Study heterogeneity ranged from low to moderate depending on the endpoint.

conclusionsEndoscopic endonasal approaches provide better visual outcomes and lower ICH risk in GPitNETs. No statistically significant differences were observed between EEAs and TCAs in terms of GTR, progressive rates, or postoperative complications, including CSF leak, infection, diabetes insipidus, and HP.

Indexed as

Neuroendocrine TumorsNeuroendoscopyNeurosurgical ProceduresPituitary NeoplasmsHumansPostoperative ComplicationsTreatment OutcomeEndoscopic endonasalGiant pituitary neuroendocrine tumorsMeta-analysisOutcomesSystematic reviewsTranscranial approach

Identifiers

PMID41699274

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.