Article
Clinical Neurology
Martin Majovsky, Andre Grotenhuis, Nicolas Foroglou, Francesco Zenga, Sebastien Froehlich, Florian Ringel, Nicolas Sampron, Nick Thomas, Martin Komarc, David Netuka
Summary: Pituitary adenoma surgery in European neurosurgical centers shows significant variation in surgical approach, postoperative care, and management of complications. High-volume centers are more proactive in dealing with cerebrospinal fluid leaks, while low-volume centers are less meticulous in sellar closure. Further discussion is needed to address these discrepancies and potentially develop standardized protocols for improved patient outcomes.
NEUROSURGICAL REVIEW
(2022)
Article
Clinical Neurology
Robert C. Osorio, Matheus P. Pereira, Rushikesh S. Joshi, Kevin C. Donohue, Patricia Sneed, Steve Braunstein, Philip Theodosopoulos, Ivan H. El-Sayed, Jose Gurrola, Sandeep Kunwar, Lewis S. Blevins, Manish K. Aghi
Summary: This study examined the influence of socioeconomic status (SES) on the clinical presentations and outcomes of nonfunctional pituitary adenoma (NFPA) resections. The presence of a primary care provider (PCP) was found to be the most important factor, affecting hospital lengths of stay, readmission rates, follow-up adherence, and tumor recurrence.
JOURNAL OF NEUROSURGERY
(2022)
Article
Endocrinology & Metabolism
Charlotte Aagaard, Amanda S. Christophersen, Susanne Finnerup, Christian Rosendal, Helga A. Gulisano, Kare S. Ettrup, Peter Vestergaard, Jesper Karmisholt, Eigil Husted Nielsen, Jakob Dal
Summary: This study investigated the prevalence and patient characteristics of acromegaly over time, as well as the impact of treatment changes on disease control. The study found that the prevalence of acromegaly has increased significantly, with a shift towards a milder clinical phenotype. Modern treatment approaches enable individualized treatment and disease control in the majority of patients with acromegaly.
CLINICAL ENDOCRINOLOGY
(2022)
Article
Clinical Neurology
Ben A. Strickland, Shane Shahrestani, Robert G. Briggs, Anna Jackanich, Sherwin Tavakol, Kyle Hurth, Mark S. Shiroishi, Chia-Shang J. Liu, John D. Carmichael, Martin Weiss, Gabriel Zada
Summary: SCAs are a subtype of NFAs that are more biologically aggressive, with patients presenting with more cranial neuropathy and headaches, and a shorter progression-free survival duration.
JOURNAL OF NEUROSURGERY
(2021)
Article
Medicine, General & Internal
Yoon-Hee Choo, Youngbeom Seo, Oh-Lyong Kim
Summary: This study retrospectively analyzed the outcomes of the transsphenoidal approach for nonfunctioning pituitary adenomas treated at a single institute. The study found that the transsphenoidal approach is an effective and safe treatment, improving visual impairment and restoring endocrine function. Diabetes insipidus was the most common complication, and complete resection during surgery helped to lower the risk of recurrence.
ANNALS OF MEDICINE
(2022)
Article
Endocrinology & Metabolism
Alies J. Dekkers, Friso de Vries, Amir H. Zamanipoor Najafabadi, Emmy M. van der Hoeven, Marco J. T. Verstegen, Alberto M. Pereira, Wouter R. van Furth, Nienke R. Biermasz
Summary: This study retrospectively assessed the healthcare costs and cost drivers in perioperative care for pituitary tumour patients. The results showed that length of hospital stay and complications were the main drivers of costs, and certain baseline features were also associated with higher costs.
FRONTIERS IN ENDOCRINOLOGY
(2022)
Article
Oncology
Jack L. Birkenbeuel, Brandon M. Lehrich, Khodayar Goshtasbi, Arash Abiri, Frank P. K. Hsu, Edward C. Kuan
Summary: This study evaluates the clinical and sociodemographic factors that predict surgery refusal in pituitary adenoma patients and the impact on overall survival. Age, race, comorbidities, and insurance status are identified as independent predictors of surgery refusal. Patients with macroadenomas who refuse surgery have a significant decrease in overall survival.
Review
Endocrinology & Metabolism
Stephanie Du Four, Jorn Van Der Veken, Johnny Duerinck, Elle Vermeulen, Corina E. E. Andreescu, Michael Bruneau, Bart Neyns, Van Velthoven, Brigitte Velkeniers
Summary: In this article, we report a case series of five patients with pituitary carcinoma (PC) and highlight the challenges in diagnosis and treatment. PCs are rare intracranial neoplasms that usually develop from aggressive pituitary adenomas. The mean time interval from initial diagnosis to PC diagnosis was 10.7 years. Various treatment approaches, including surgery, radiotherapy, temozolomide, and immunotherapy, were used, with some patients achieving stable disease. The lack of predictive factors for an aggressive clinical course makes management challenging for PCs.
FRONTIERS IN ENDOCRINOLOGY
(2022)
Article
Clinical Neurology
Georgios Mantziaris, Stylianos Pikis, Tomas Chytka, Roman Liscak, Kimball Sheehan, Darrah Sheehan, Selcuk Peker, Yavuz Samanci, Shray K. Bindal, Ajay Niranjan, L. Dade Lunsford, Rupinder Kaur, Renu Madan, Manjul Tripathi, Dhiraj J. Pangal, Ben A. Strickland, Gabriel Zada, Anne-Marie Langlois, David Mathieu, Ronald E. Warnick, Samir Patel, Zayda Minier, Herwin Speckter, Zhiyuan Xu, Rithika Kormath Anand, Jason P. Sheehan
Summary: This study analyzed 375 patients with residual nonfunctioning pituitary adenomas (NFPAs) who were treated with stereotactic radiosurgery (SRS) and compared the outcomes between early treatment and treatment at progression. The results showed that there was no significant difference in tumor control and preservation of hormonal/visual function between SRS at residual NFPA progression and adjuvant SRS. Deferring radiosurgical management to the time of radiological progression could prolong the onset of radiosurgically induced pituitary dysfunction.
JOURNAL OF NEUROSURGERY
(2023)
Article
Clinical Neurology
Lea M. Alhilali, Andrew S. Little, Kevin C. J. Yuen, Jae Lee, Timothy K. Ho, Saeed Fakhran, William L. White
Summary: In this study of 102 patients undergoing microscopic transsphenoidal resection of a pituitary adenoma, early postoperative MRI showed high sensitivity and specificity for detecting residual tumors, with better reliability than late postoperative MRI. Early MRI identified 4 residual tumors that were missed by intraoperative assessment and late MRI, providing important guidance for reoperation in select patients.
JOURNAL OF NEUROSURGERY
(2021)
Article
Clinical Neurology
Christina E. Sarris, Scott T. Brigeman, Estelle Doris, Maggie Bobrowitz, Thomas Rowe, Eva M. Duran, Griffin D. Santarelli, Ryan M. Rehl, Garineh Ovanessoff, Monica C. Rodriguez, Kajalben Buddhdev, Kevin C. J. Yuen, Andrew S. Little
Summary: After implementing a comprehensive quality improvement program for pituitary surgery patients, there were significant improvements in patient outcomes, decreased outcome variability, and enhanced hospital financial performance. Future studies may provide further insight into disease remission, patient satisfaction, and how the surgeon learning curve impacts quality efforts.
JOURNAL OF NEUROSURGERY
(2021)
Article
Clinical Neurology
Alexander Micko, Matthew S. Agam, Andrew Brunswick, Ben A. Strickland, Martin J. Rutkowski, John D. Carmichael, Mark S. Shiroishi, Gabriel Zada, Engelbert Knosp, Stefan Wolfsberger
Summary: The aim of this study is to assess the treatment strategies and outcomes of giant pituitary adenomas (GPAs) in the era of endoscopic transsphenoidal surgery (ETS). The study found that the extent of resection is dependent on the morphology of the GPA. Treatment strategies for residual pituitary adenoma include early transcranial reoperation, delayed endoscopic transsphenoidal/transcranial reoperation, and adjuvant radiosurgery.
JOURNAL OF NEUROSURGERY
(2022)
Article
Clinical Neurology
Siyuan Yu, Mohammad Taghvaei, Sarah Collopy, Keenan Piper, Michael Karsy, Pascal Lavergne, Blair Barton, Chandala Chitguppi, Glen D'Souza, Marc R. Rosen, Gurston G. Nyquist, Mindy Rabinowitz, Christopher J. Farrell, James J. Evans
Summary: This study demonstrated that discharge on postoperative day 1 after endonasal transsphenoidal surgery (ETS) for pituitary adenomas was safe and feasible without an increased risk of readmission within 30 days. Factors associated with increased risk of prolonged length of stay included diabetes insipidus (DI) and intraoperative cerebrospinal fluid leak, while the surgical epoch was associated with decreased risk of prolonged length of stay.
JOURNAL OF NEUROSURGERY
(2022)
Article
Clinical Neurology
Rupa G. Juthani, Anne S. Reiner, Ankur R. Patel, Aimee Cowan, Marie Roguski, Katherine S. Panageas, Eliza B. Geer, Sasan Karimi, Marc A. Cohen, Viviane Tabar
Summary: The study evaluated the safety and efficacy of iMRI for pituitary adenoma resection, comparing endoscopic transsphenoidal and microscopic transsphenoidal approaches. Results showed that iMRI can improve the extent of resection for pituitary adenomas while preserving hormone function, with low rates of postoperative complications.
JOURNAL OF NEUROSURGERY
(2021)
Article
Endocrinology & Metabolism
Nasrin Al-Shamkhi, Katarina Berinder, Henrik Borg, Pia Burman, Per Dahlqvist, Charlotte Hoybye, Daniel S. Olsson, Oskar Ragnarsson, Bertil Ekman, Britt Eden Engstrom
Summary: Objective data on pituitary function before and after transsphenoidal surgery in nonfunctioning pituitary adenomas were inconsistent. This study found that adrenocorticotrophic hormone deficiency increased significantly at 1 year postoperatively, while other axis function changes were not significant. Therefore, continuous individual evaluations are needed during longer follow-up of patients operated for NFPA.
EUROPEAN JOURNAL OF ENDOCRINOLOGY
(2023)