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.
基金:
National Natural Science Foundation of China [81270865, 82173136]; Transformation and Cultivation Project of Tongji Hospital [2016ZHYX21]
第一作者单位:[1]Huazhong Univ Sci & Technol,Tongji Hosp,Dept Neurosurg,Tongji Med Coll,Wuhan 430030,Peoples R China[2]Huazhong Univ Sci & Technol,Tongji Hosp,Tongji Med Coll,Sino German Neuro Oncol Mol Lab,Wuhan 430030,Peoples R China
通讯作者:
通讯机构:[1]Huazhong Univ Sci & Technol,Tongji Hosp,Dept Neurosurg,Tongji Med Coll,Wuhan 430030,Peoples R China[2]Huazhong Univ Sci & Technol,Tongji Hosp,Tongji Med Coll,Sino German Neuro Oncol Mol Lab,Wuhan 430030,Peoples R China
推荐引用方式(GB/T 7714):
Lu Liang,Wan Xueyan,Xu Yu,et al.Classifying Pituitary Adenoma Invasiveness Based on Radiological, Surgical and Histological Features: A Retrospective Assessment of 903 Cases[J].JOURNAL OF CLINICAL MEDICINE.2022,11(9):doi:10.3390/jcm11092464.
APA:
Lu, Liang,Wan, Xueyan,Xu, Yu,Chen, Juan,Shu, Kai&Lei, Ting.(2022).Classifying Pituitary Adenoma Invasiveness Based on Radiological, Surgical and Histological Features: A Retrospective Assessment of 903 Cases.JOURNAL OF CLINICAL MEDICINE,11,(9)
MLA:
Lu, Liang,et al."Classifying Pituitary Adenoma Invasiveness Based on Radiological, Surgical and Histological Features: A Retrospective Assessment of 903 Cases".JOURNAL OF CLINICAL MEDICINE 11..9(2022)