ArticleFrontiers in neurology
Predicting tumor progression in non-functioning pituitary macroadenomas following transnasal transsphenoidal resection: insights from a single-center retrospective cohort study.
Article in Frontiers in neurology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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6 authors.
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Abstract
Introduction: This retrospective, single-center study aimed to identify predictive factors for progression in postoperative residual findings of non-functioning pituitary macroadenomas (NFPMAs). The findings are intended to support individualized decisions regarding follow-up and adjuvant therapy. Methods: A retrospective analysis was conducted on 212 patients treated at a tertiary referral center between 2007 and 2023. Patients underwent MRI-guided, transnasal transsphenoidal surgery for histologically confirmed NFPMAs. Pre- and postoperative tumor volumes were assessed alongside demographic, clinical, and histopathological data. Tumor configuration was classified using Hardy and Knosp scales. Subgroups were defined based on postoperative imaging: stable residuals, progressive residuals, or recurrence after gross total resection (GTR). Statistical analyses included multivariate testing and ROC analysis to determine predictive cutoff values. Results: Of the 212 patients, initial radiological gross total resection (GTR) was achieved in 94/212 (44.3%); during follow-up, 62/212 (29.2%) had durable complete resection without recurrence, while 32/212 (15.1%) developed recurrence after initial GTR. Among patients with residual findings, 76 (64.4%) exhibited stable tumors after a mean of follow-up of 39 months, while 42 (35.6%) showed progression, which correlated significantly with larger preoperative tumor volumes (median: 11.6 cm Conclusion: According to our study, preoperative and postoperative tumor volumes represent pragmatic prognostic markers of progression in NFPMAs, with a critical cutoff of 7.12 cm
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