Classifying Pituitary Adenoma Invasiveness Based on Radiological, Surgical and Histological Features: A Retrospective Assessment of 903 Cases
Invasiveness is a major predictor of surgical outcome and long-term prognosis in patients with pituitary adenomas (PAs). We assessed PA invasiveness via radiological, surgical and histological perspectives to establish a classification scheme for predicting invasive behavior and poor prognosis. We r...
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MDPI AG
2022-04-01
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| Series: | Journal of Clinical Medicine |
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| author | Liang Lu Xueyan Wan Yu Xu Juan Chen Kai Shu Ting Lei |
| author_facet | Liang Lu Xueyan Wan Yu Xu Juan Chen Kai Shu Ting Lei |
| author_sort | Liang Lu |
| collection | DOAJ |
| description | Invasiveness is a major predictor of surgical outcome and long-term prognosis in patients with pituitary adenomas (PAs). We assessed PA invasiveness via radiological, surgical and histological perspectives to establish a classification scheme for predicting invasive behavior and poor prognosis. We retrospectively analyzed 903 patients who underwent transnasal-transsphenoidal surgery between January 2013 and December 2019. Radiological (hazard ratio (HR) 5.11, 95% confidence interval (CI): 3.98–6.57, <i>p</i> < 0.001) and surgical (HR 6.40, 95% CI: 5.09–8.06, <i>p</i> < 0.001) invasiveness better predicted gross-total resection (GTR) and recurrence/progression-free survival (RPFS) rates than did histological invasiveness (HR 1.44, 95% CI: 1.14–1.81, <i>p</i> = 0.003). Knosp grades 2 (HR 4.63, 95% CI: 2.13–10.06, <i>p</i> < 0.001) and 3 (HR 2.23, 95% CI: 1.39–3.59, <i>p</i> = 0.011) with surgical invasiveness were better predictors of prognosis than corresponding Knosp grades without surgical invasiveness. Classifications 1 and 2 were established based on radiological, surgical and histological invasiveness, and Knosp classification and surgical invasiveness, respectively. Classification 2 predicted RPFS better than Knosp classification and Classification 1. Overall, radiological and surgical invasiveness were clinically valuable as prognostic predictors. The convenience and good accuracy of Invasiveness in Classification 2 is useful for identifying invasive PAs and facilitating the development of treatment plans. |
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| series | Journal of Clinical Medicine |
| spelling | doaj.art-2529d2fab64646018de6e70e7c431a1f2023-11-23T08:32:43ZengMDPI AGJournal of Clinical Medicine2077-03832022-04-01119246410.3390/jcm11092464Classifying Pituitary Adenoma Invasiveness Based on Radiological, Surgical and Histological Features: A Retrospective Assessment of 903 CasesLiang Lu0Xueyan Wan1Yu Xu2Juan Chen3Kai Shu4Ting Lei5Department of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, ChinaDepartment of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, ChinaDepartment of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, ChinaDepartment of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, ChinaDepartment of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, ChinaDepartment of Neurosurgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, ChinaInvasiveness is a major predictor of surgical outcome and long-term prognosis in patients with pituitary adenomas (PAs). We assessed PA invasiveness via radiological, surgical and histological perspectives to establish a classification scheme for predicting invasive behavior and poor prognosis. We retrospectively analyzed 903 patients who underwent transnasal-transsphenoidal surgery between January 2013 and December 2019. Radiological (hazard ratio (HR) 5.11, 95% confidence interval (CI): 3.98–6.57, <i>p</i> < 0.001) and surgical (HR 6.40, 95% CI: 5.09–8.06, <i>p</i> < 0.001) invasiveness better predicted gross-total resection (GTR) and recurrence/progression-free survival (RPFS) rates than did histological invasiveness (HR 1.44, 95% CI: 1.14–1.81, <i>p</i> = 0.003). Knosp grades 2 (HR 4.63, 95% CI: 2.13–10.06, <i>p</i> < 0.001) and 3 (HR 2.23, 95% CI: 1.39–3.59, <i>p</i> = 0.011) with surgical invasiveness were better predictors of prognosis than corresponding Knosp grades without surgical invasiveness. Classifications 1 and 2 were established based on radiological, surgical and histological invasiveness, and Knosp classification and surgical invasiveness, respectively. Classification 2 predicted RPFS better than Knosp classification and Classification 1. Overall, radiological and surgical invasiveness were clinically valuable as prognostic predictors. The convenience and good accuracy of Invasiveness in Classification 2 is useful for identifying invasive PAs and facilitating the development of treatment plans.https://www.mdpi.com/2077-0383/11/9/2464pituitary adenomainvasivenessclassificationcavernous sinusradiologysurgery |
| spellingShingle | Liang Lu Xueyan Wan Yu Xu Juan Chen Kai Shu Ting Lei Classifying Pituitary Adenoma Invasiveness Based on Radiological, Surgical and Histological Features: A Retrospective Assessment of 903 Cases Journal of Clinical Medicine pituitary adenoma invasiveness classification cavernous sinus radiology surgery |
| title | Classifying Pituitary Adenoma Invasiveness Based on Radiological, Surgical and Histological Features: A Retrospective Assessment of 903 Cases |
| title_full | Classifying Pituitary Adenoma Invasiveness Based on Radiological, Surgical and Histological Features: A Retrospective Assessment of 903 Cases |
| title_fullStr | Classifying Pituitary Adenoma Invasiveness Based on Radiological, Surgical and Histological Features: A Retrospective Assessment of 903 Cases |
| title_full_unstemmed | Classifying Pituitary Adenoma Invasiveness Based on Radiological, Surgical and Histological Features: A Retrospective Assessment of 903 Cases |
| title_short | Classifying Pituitary Adenoma Invasiveness Based on Radiological, Surgical and Histological Features: A Retrospective Assessment of 903 Cases |
| title_sort | classifying pituitary adenoma invasiveness based on radiological surgical and histological features a retrospective assessment of 903 cases |
| topic | pituitary adenoma invasiveness classification cavernous sinus radiology surgery |
| url | https://www.mdpi.com/2077-0383/11/9/2464 |
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