Evaluating pituitary tumor management: aligning with pituitary tumor centers of excellence criteria

The Pituitary Society established criteria to develop Pituitary Tumor Centers of Excellence (PTCOE) for optimization of patient care. These criteria were later transformed into quantitative standards based on real-life data from accredited pituitary centers worldwide. The aim of this study was to evaluate the pituitary tumor care capacity at our institute and compare it with the PTCOE criteria.

We retrospectively reviewed the data of patients who underwent sellar, suprasellar, or parasellar surgery during 2021-2023 at Taipei Veterans General Hospital. Adults older than 18 years who were diagnosed with pituitary tumors were included. We collected data regarding baseline patient and tumor characteristics, the surgical method, complications, and activity volumes across involved departments. The relevant data were compared with those of the PTCOE standards.

In total, 182 patients with pituitary tumors underwent surgery via the endoscopic endonasal approach during 2021-2023. Their median age was 51 (range, 20-91) years. Among them, 90.7% had macroadenomas. Functional remission rates were 55.6% for acromegaly, 69.2% for prolactinoma, and 93.3% for Cushing's disease. Our institute met the acceptable PTCOE criteria for the number of pituitary interventions, postoperative readmissions for complications, dynamic endocrine tests, neuroradiologists, and neuro-oncologists. Further, we met the preferred PTCOE criteria for mortality rate and the numbers of dedicated surgeons, endocrinologists, trained nurses, neuropathologists, and neuro-ophthalmologists.

Most indicators in our study met the acceptable standards for a PTCOE. During the study period, the multidisciplinary team at our institute collaborated closely to provide comprehensive care for patients with pituitary adenomas.