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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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Autores principales: Lu, Liang, Wan, Xueyan, Xu, Yu, Chen, Juan, Shu, Kai, Lei, Ting
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9104472/
https://www.ncbi.nlm.nih.gov/pubmed/35566590
http://dx.doi.org/10.3390/jcm11092464
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author Lu, Liang
Wan, Xueyan
Xu, Yu
Chen, Juan
Shu, Kai
Lei, Ting
author_facet Lu, Liang
Wan, Xueyan
Xu, Yu
Chen, Juan
Shu, Kai
Lei, Ting
author_sort Lu, Liang
collection PubMed
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, p < 0.001) and surgical (HR 6.40, 95% CI: 5.09–8.06, p < 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, p = 0.003). Knosp grades 2 (HR 4.63, 95% CI: 2.13–10.06, p < 0.001) and 3 (HR 2.23, 95% CI: 1.39–3.59, p = 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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spelling pubmed-91044722022-05-14 Classifying Pituitary Adenoma Invasiveness Based on Radiological, Surgical and Histological Features: A Retrospective Assessment of 903 Cases Lu, Liang Wan, Xueyan Xu, Yu Chen, Juan Shu, Kai Lei, Ting J Clin Med Article 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, p < 0.001) and surgical (HR 6.40, 95% CI: 5.09–8.06, p < 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, p = 0.003). Knosp grades 2 (HR 4.63, 95% CI: 2.13–10.06, p < 0.001) and 3 (HR 2.23, 95% CI: 1.39–3.59, p = 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. MDPI 2022-04-27 /pmc/articles/PMC9104472/ /pubmed/35566590 http://dx.doi.org/10.3390/jcm11092464 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Lu, Liang
Wan, Xueyan
Xu, Yu
Chen, Juan
Shu, Kai
Lei, Ting
Classifying Pituitary Adenoma Invasiveness Based on Radiological, Surgical and Histological Features: A Retrospective Assessment of 903 Cases
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 Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9104472/
https://www.ncbi.nlm.nih.gov/pubmed/35566590
http://dx.doi.org/10.3390/jcm11092464
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