A Prospective, Multicenter, Observational Study of Surgical vs Nonsurgical Management for Pituitary Apoplexy
Authors' conclusion
We found that medical and surgical management of PA yield similar 3-month outcomes. Although patients undergoing surgery had more severe visual field deficits, we could not clearly demonstrate that surgery led to better outcomes. Even without surgery, apoplectic tumor volumes regress substantially within 2 to 3 months, indicating that surgery is not always needed to reduce mass effect.
Study context
- Population
- Consecutive patients with pituitary apoplexy (PA), 12 hospitals97 evaluable
- Participants
- 100 patients
- Exposure
- Surgery vs medical management alone
- Surgicaln = 67
- Medicaln = 30reference
- Outcome
- Hormonal, visual and oculomotor outcomes
- Follow-up
- 3 and 6 months
Methodological detailsmulticenter, international, prospective registry, Treatment determined independently by each site
- Multicenter
- International
- Prospective registry
- Treatment determined independently by each site
Main finding
As reported in the abstract
- Hormonal, visual and oculomotor outcomes were similar between surgical and medical management at 3 and 6 months
Observational data: associations, not effects.
Further findings
Outcomes stratified by severity of visual field deficit · 3 months
- No difference in any outcome
Timing of surgery
- Timing of surgery did not affect outcomes
Baseline severe temporal visual field deficit · admission
- More common in surgical patients
Original publication
A Prospective, Multicenter, Observational Study of Surgical vs Nonsurgical Management for Pituitary Apoplexy. J Clin Endocrinol Metab. Published 12 September 2023. doi:10.
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