Comparative analysis of intraoperative and imaging features of invasive growth in pituitary adenomas
Authors' conclusion
Both intraoperative and radiographic signs of invasive growth are high-risk lesions for incomplete extent of resection and occur more frequently in older patients. A particularly high prevalence of invasion can be found in the SGCA and SGSA types. Cavernous sinus invasion is also more common in gonadotroph adenomas. Usage of the Knosp classification is a valuable preoperative estimation tool.
Study context
- Population
- Surgically treated pituitary adenomas, October 2004–April 2018
- Participants
- 764 pituitary adenomas (PAs)
- Exposure
- Intraoperative vs magnetic resonance imaging (MRI) assessment of invasive growth
- Outcome
- Invasive growth
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
Invasive features on MRI (Knosp grades 3A-4)
24.4%
186/764
Intraoperative invasion
42.4%
324/764
Observational data: associations, not effects.
Further findings
Extent of resection
- Complete resection
- 80.0%
- Subtotal resection
- 20.1%
Factors associated with intraoperative invasion (multivariate)
- Sparsely granulated corticotroph adenoma (SGCA)
- P = 0.0026
- Sparsely granulated somatotroph adenoma (sparsely granulated somatotroph (SGSA))
- P = 0.0103
- Age
- P = 0.0287
Factors correlated with radiographic invasion (Knosp grades 3A-4)
- Age
- P = 0.0098
- SGCAs
- P = 0.0005
- SGSAs
- P = 0.0351
- Gonadotroph adenomas
- P = 0.0478
Invasion (both criteria) and subtotal resection
- Both criteria of invasion correlated with subtotal resection
- P = 0.0001, respectively
Original publication
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