Results and risk factors for recurrence following endoscopic endonasal transsphenoidal surgery for pituitary adenoma

Bodhinayake, Imithri; Ottenhausen, Malte; Mooney, Michael A.; Kesavabhotla, Kartik; Christos, Paul J.; Schwarz, Joshua L.; Boockvar, John A.

doi:10.1016/j.clineuro.2014.01.020

Cited by 33 publications

(23 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The GTR rate of endoscopic surgery for PA varies widely from 62% to 94%, with most reports around 70% [14,15,[27][28][29][30][31][32]. In our study, the assessment of resection was determined by the postoperative MR images, and GTR was achieved in 126 patients (73.68%), similar to that reported by other studies.…”

Section: Gtrsupporting

confidence: 75%

Extended endoscopic endonasal approach for pituitary adenoma: a single-center experience of 171 patients

et al. 2017

View full text Add to dashboard Cite

show abstract

Section: Gtrsupporting

confidence: 75%

Extended endoscopic endonasal approach for pituitary adenoma: a single-center experience of 171 patients

et al. 2017

View full text Add to dashboard Cite

show abstract

“…Sometimes, a more complete resection is correlated with a decreased rate of tumor recurrence and improved outcomes but this is not the case universally (17). At our institution, however, we found similar or somehow better results in the rate of intra-operatively complications and post-operative residue in our pediatric microscopic endonasal patients than the results reported for endoscopic endonasal surgeries in other series (10,(12)(13)(14)18,19). In our opinion, fewer post-operative complications of microscopic approach in pediatrics patients is due to lesser exposure which is imposed during surgery.…”

Section: Discussionsupporting

confidence: 50%

“…On the other hand, tumor remnants or repeated surgeries do not change the quality of life for many patients. Also, deciding on a radical surgery must be carefully balanced against the risk and ramifications of surgical morbidity (10). Despite the promising articles about endoscopic endonasal (2) approach, the limitations of endoscopic endonasal (2) approach include post-operative nasal complaints as well as risk for post-operative CSF leak.…”

Section: Introductionmentioning

confidence: 99%

Microscopic Transsphenoidal Surgery for Pituitary Adenomas in Children and Adolescents

Shirvani

Hajimirzabeigi

Jafari

et al. 2015

IrJNS

View full text Add to dashboard Cite

Background & Aim: We described the presentation, management and subsequent treatment outcomes of children and adolescents diagnosed with a pituitary adenoma in a joint neuroendocrine setting followed up by a single service as well as assessing long-term outcomes in terms of endocrine status and neurology symptoms. Methods & Materials/Patients: A total of 21 participants with histologically verified pituitary adenoma between January 2011 and June 2014 were studied. Patients' data from clinical, radiological and pathological records were analyzed using SPSS (Version 16). Results: All these children and adolescents with pituitary adenomas were managed with microscopic transsphenoidal surgery. The most common symptom was Cushing (47.6%, n=10). The functional type (76.2%, n=16) was more than the non-functional. The post-operative control MRI of most of them was clear (90.5%, n=19). The lab control of most of them was normal (76.2%, n=16). Apoplexy was seen in 5 patients (33.8%). Gross-total resection (GTR; 100% tumor removal as judged by early post-operative imaging) was achieved in 19 cases. Only one of these patients showed evidence of radiologic recurrence. Conclusion: In our study, all patients underwent microscopic transsphenoidal surgery due to limitation of endoscopic approach in pediatric and avoided wide anatomical deficit. Doing a comparative study between these two approaches will bring about promising results.

show abstract

“…Even so, the recurrence rate in this cohort (31%) was in the range of that reported in previous studies. 14,28 Presumably, longer follow-up would correspond to more MRIs and thereby a higher cost to detect clinically significant change but also to a higher rate of detected recurrences as predicted by the Kaplan-Meier curve. Without long-term data from a large population, we are unable to assess the length of time for which annual MRI scans may be cost effective.…”

Section: Discussionmentioning

confidence: 99%

Imaging of Resected Nonfunctioning Pituitary Adenomas: The Cost of Surveillance

et al. 2015

View full text Add to dashboard Cite

Objectives To determine the cost of annual magnetic resonance imaging (MRI) surveillance after resection of nonfunctioning pituitary adenomas (NFPAs) and its effectiveness in reducing visual compromise due to tumor recurrence. Design Retrospective case series. Setting Vanderbilt University Medical Center (2003-2011). Participants A total of 120 patients underwent primary transsphenoidal resection and surveillance of NFPAs between 2003 and 2011. Main Outcome Measures Time from initial surgery to most recent imaging or progression. Surveillance MRI costs according to Centers for Medicare and Medicaid database and visual field deficits. Results Patients received 382 surveillance scans at a total cost of $218,477.30. The median follow-up was 47 months (interquartile range [IQR]: 26-76), and the median interval between scans was 357 days (IQR: 225-434). Overall, 50 scans (13%) revealed tumor growth. The cost per scan revealing growth was $4,369.55. The cost to identify 19 patients (16%) with clinically significant growth was $11,498.80 per patient. A total of 5 of 19 patients (26%) experienced new visual deficits prior to intervention. Patients with visual decline tended to have longer scan intervals than those with preserved vision (mean: 239 versus 794 days; p = 0.0584). No patient with annual surveillance imaging experienced visual decline. Conclusions Annual MRI scans are a sensitive and cost-conscious method to identify NFPA recurrence prior to visual decline.

show abstract

Results and risk factors for recurrence following endoscopic endonasal transsphenoidal surgery for pituitary adenoma

Cited by 33 publications

References 28 publications

Extended endoscopic endonasal approach for pituitary adenoma: a single-center experience of 171 patients

Extended endoscopic endonasal approach for pituitary adenoma: a single-center experience of 171 patients

Microscopic Transsphenoidal Surgery for Pituitary Adenomas in Children and Adolescents

Imaging of Resected Nonfunctioning Pituitary Adenomas: The Cost of Surveillance

Contact Info

Product

Resources

About