Hormone outcomes following endoscopic endonasal resection of nonfunctional pituitary adenomas

作者：Evan D. Bander, Abhinav Pandey, Carson Gundlach, Ying Li, Miguel Tusa Lavieri, Paul J. Christos, Georgiana Dobri, Theodore H. Schwartz · 发表于：Journal of neurosurgery · 年份：2025 · DOI：10.3171/2024.11.jns241242 · 被引用次数：6 · 研究领域：Pituitary Gland Disorders and Treatments、Head and Neck Surgical Oncology、Cerebrospinal fluid and hydrocephalus

OBJECTIVE: Resection of nonfunctional pituitary adenomas (NFPAs) can precipitate transient, or in some cases, permanent hormone deficits requiring replacement. Predicting the risk of permanent hormone dysfunction and the possibility of improvement postsurgery is crucial for patient counseling. This study analyzed a large cohort of patients with NFPA to assess predictors of postoperative hormone function and to help both surgeons and patients better predict outcomes. METHODS: The authors conducted a retrospective single-institution study on a series of patients treated for NFPAs at Weill Cornell Medicine between 2006 and 2023. Data including demographics, preoperative hormone status, laboratory values, pathological and radiographic tumor characteristics, and postoperative transient and permanent hormone replacement were collected. Multivariable logistic regression analysis was used to identify predictors of hormone deterioration and improvement. RESULTS: A cohort of 372 patients were included in this study, 56% of whom presented with preoperative hormone deficiency of at least one axis. A total of 79% of patients underwent gross-total or near-total resection. Postoperatively, 178 (48%) required permanent hormone replacement for at least one hormonal axis: thyroid (34%), cortisol (23%), gonadotropin (15%), and antidiuretic hormone (7%). In patients with no preoperative endocrinopathy, 30.8% needed new hormone replacement therapy. Apoplexy and tumor size were strong predictors. ...