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Updated: Jul 25, 2025
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Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
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Postsurgical outcomes of nonfunctioning pituitary adenomas: a patient-level meta-analysis
Khi Yung Fong1, Mervyn Jun Rui Lim2,3, Shuning Fu1
1Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Pituitary
|June 30, 2023
Summary
Complete surgical resection (GTR) improves progression-free survival (PFS) for nonfunctioning pituitary adenomas (NFPA). Postoperative radiotherapy benefits patients, especially those with subtotal resection (STR), while surgical approach has no significant impact on long-term outcomes.
Area of Science:
- Neurosurgery
- Endocrinology
- Oncology
Background:
- Nonfunctioning pituitary adenomas (NFPA) are typically treated with surgical resection.
- Analyzing factors influencing long-term outcomes in NFPA is crucial for patient management.
Approach:
- Individual patient data (IPD) meta-analysis of 11 studies (3941 patients) on surgically resected NFPA.
- Compared outcomes based on surgical approach (endoscopic endonasal vs. microscopic transsphenoidal), resection completeness (gross total vs. subtotal), and use of postoperative radiotherapy.
Key Points:
- Gross total resection (GTR) significantly improves progression-free survival (PFS) compared to subtotal resection (STR).
- Postoperative radiotherapy significantly enhances PFS, particularly in patients with STR.
- Endoscopic endonasal surgery (EES) and microscopic transsphenoidal surgery (MTS) showed similar long-term PFS.
Conclusions:
- GTR should be the standard surgical approach for NFPA.
- Postoperative radiotherapy offers significant benefits, especially for patients with incomplete resection.
- Surgical technique does not substantially influence the long-term prognosis of NFPA.
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