Vanessa Briceno1, Hasan A Zaidi2,3, Joanne A Doucette1, Kaho B Onomichi1, Amer Alreshidi1, Rania A Mekary1,2, Timothy R Smith1,2. 1. a Department of Pharmaceutical Business and Administrative Sciences , MCPHS University , Boston , MA , USA. 2. b Department of Neurosurgery , Cushing Neurosurgery Outcomes Center, Brigham and Women's Hospital, Harvard Medical School , Boston , MA , USA. 3. c Department of Neurosurgery , Barrow Neurological Institute, St. Joseph's Hospital and Medical Center , Phoenix , AZ , USA.
Abstract
OBJECTIVES: Growth hormone-secreting pituitary adenomas in adults can result in severe craniofacial disfigurement and potentially fatal medical complications. Surgical resection leading to remission of the disease is dependent on complete surgical resection of the tumor. Lesions that invade the cavernous sinus may not be safely accessible via an endonasal transsphenoidal surgery (TSS), and the rates of biochemical remission of patients with residual disease vary widely in the literature. We conducted a meta-analysis to examine the prevalence of biochemical remission after TSS among patients with growth hormone-secreting pituitary adenomas with and without cavernous sinus invasion. METHODS: Embase, PubMed, and Cochrane Library databases were searched for relevant publications. Fourteen studies with 972 patients with biochemically confirmed growth hormone-secreting pituitary adenomas were included in the meta-analysis. RESULTS: The overall remission prevalence under a fixed-effect model was 47.6% (95% CI = 40.8-54.4%) for patients with invasive macroadenomas (I2 = 74.6%, p < 0.01); 76.4% (95% CI = 72.2-80.1%) for patients with non-invasive macroadenomas (I2 = 59.6%, p = 0.03); and 74.2% (95% CI = 66.3-80.7%) for patients with non-invasive microadenomas (I2 = 36.4, p = 0.10). The significant difference among the three groups resulted from the difference between patients with or without cavernous sinus invasion (p = 0.01) and not from the size of adenomas among those without cavernous sinus invasion (p = 0.66). DISCUSSION: The prevalence of biochemical remission in patients with cavernous sinus invasion was lower than in patients without cavernous sinus invasion after TSS for acromegaly.
OBJECTIVES:Growth hormone-secreting pituitary adenomas in adults can result in severe craniofacial disfigurement and potentially fatal medical complications. Surgical resection leading to remission of the disease is dependent on complete surgical resection of the tumor. Lesions that invade the cavernous sinus may not be safely accessible via an endonasal transsphenoidal surgery (TSS), and the rates of biochemical remission of patients with residual disease vary widely in the literature. We conducted a meta-analysis to examine the prevalence of biochemical remission after TSS among patients with growth hormone-secreting pituitary adenomas with and without cavernous sinus invasion. METHODS: Embase, PubMed, and Cochrane Library databases were searched for relevant publications. Fourteen studies with 972 patients with biochemically confirmed growth hormone-secreting pituitary adenomas were included in the meta-analysis. RESULTS: The overall remission prevalence under a fixed-effect model was 47.6% (95% CI = 40.8-54.4%) for patients with invasive macroadenomas (I2 = 74.6%, p < 0.01); 76.4% (95% CI = 72.2-80.1%) for patients with non-invasive macroadenomas (I2 = 59.6%, p = 0.03); and 74.2% (95% CI = 66.3-80.7%) for patients with non-invasive microadenomas (I2 = 36.4, p = 0.10). The significant difference among the three groups resulted from the difference between patients with or without cavernous sinus invasion (p = 0.01) and not from the size of adenomas among those without cavernous sinus invasion (p = 0.66). DISCUSSION: The prevalence of biochemical remission in patients with cavernous sinus invasion was lower than in patients without cavernous sinus invasion after TSS for acromegaly.
Authors: Amy A Swanson; Dana Erickson; Diane Mary Donegan; Sarah M Jenkins; Jamie J Van Gompel; John L D Atkinson; Bradley J Erickson; Caterina Giannini Journal: Pituitary Date: 2020-10-19 Impact factor: 4.107
Authors: M Araujo-Castro; E Pascual-Corrales; V Martínez-Vaello; G Baonza Saiz; J Quiñones de Silva; A Acitores Cancela; A M García Cano; V Rodríguez Berrocal Journal: J Endocrinol Invest Date: 2020-05-21 Impact factor: 4.256
Authors: Brandon P Galm; Colleen Buckless; Brooke Swearingen; Martin Torriani; Anne Klibanski; Miriam A Bredella; Nicholas A Tritos Journal: Pituitary Date: 2020-06 Impact factor: 4.107
Authors: Martin Hanson; Hao Li; Eliza Geer; Sasan Karimi; Viviane Tabar; Marc A Cohen Journal: World J Otorhinolaryngol Head Neck Surg Date: 2020-03-20
Authors: Renato Cozzi; Maria R Ambrosio; Roberto Attanasio; Alessandro Bozzao; Laura De Marinis; Ernesto De Menis; Edoardo Guastamacchia; Andrea Lania; Giovanni Lasio; Francesco Logoluso; Pietro Maffei; Maurizio Poggi; Vincenzo Toscano; Michele Zini; Philippe Chanson; Laurence Katznelson Journal: Endocr Metab Immune Disord Drug Targets Date: 2020 Impact factor: 2.895