ArticleBrain & spine2026
Preoperative risk stratification for recurrence after gross total resection of non-functioning pituitary macroadenomas: The role of tumor volume and 3D anatomical complexity - A retrospective single-center cohort study.
Article in Brain & spine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Recurrence after radiologically confirmed gross total resection (GTR) of non-functioning pituitary macroadenomas (NFPMAs) remains a relevant clinical challenge. Research question: Which preoperative and perioperative factors are associated with recurrence after radiological GTR of NFPMAs? Material and methods: We retrospectively analyzed 212 patients who underwent MRI-guided transnasal transsphenoidal surgery for histologically confirmed NFPMAs between 2007 and 2023 at a single tertiary neurosurgical center. Among these, 94 patients were classified as having radiological GTR based on postoperative MRI and longitudinal interdisciplinary review; 62 showed no recurrence and 32 developed recurrence during follow-up. Demographic variables, tumor configuration, suprasellar and cavernous sinus extension, surgical characteristics, histopathology, volumetric measurements, and pre-/postoperative cortisol levels were evaluated. Tumor volumes were manually segmented. Statistical comparisons included Mann-Whitney U tests, chi-squared tests, and ROC analysis. Results: Patients in the recurrence subgroup were significantly younger (mean age, 51.2 vs. 57.1 years; p = 0.008) and had significantly larger preoperative tumor volumes (10.45 cm Discussion and conclusion: Larger tumor volume and more invasive radiological configuration were associated with recurrence despite radiological GTR. These parameters may help refine postoperative surveillance strategies. Prospective validation is warranted.
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