Starting point for benchmarking outcomes and reporting of pituitary adenoma surgery
within the European Reference Network on Rare Endocrine Conditions (Endo-ERN)
Zamanipoor Najafabadi, Amir H ✉; van der Meulen, Merel; Priego Zurita, Ana Luisa; Faisal Ahmed, S; van Furth, Wouter R; Charmandari, Evangelia; Hiort, Olaf; Pereira, Alberto M; Dattani, Mehul; Vitali, Diana; de Graaf, Johan P; Biermasz, Nienke R; Steenvoorden, D [Collaborator]; Bowring, I [Collaborator]; MTG6 Pituitary of Endo-ERN [Collaborative Organization]; van der Klauw, M M [Collaborator]; Vergeer, R A [Collaborator]; Losa, M [Collaborator]; Mortini, P [Collaborator]; Drake, W [Collaborator]; Grieve, J [Collaborator]; Didi, M [Collaborator]; Mallucci, C [Collaborator]; Shaikh, M G [Collaborator]; Hassan, S [Collaborator]; Jorgensen, J O L [Collaborator]; Albarazi, M [Collaborator]; Zaharieva, S [Collaborator]; Hadzhiyanev, A [Collaborator]; Tóth, M [Tóth, Miklós (Belgyógyászat, En...), Collaborator] Department of Internal
Medicine and Oncology (SU / FM / C); Sípos, L [Collaborator]; Unuane, D [Collaborator]; D'Haens, J [Collaborator]; Feldt-Rasmussen, U [Collaborator]; Poulsgaard, L [Collaborator]; Brue, T [Collaborator]; Dufour, H [Collaborator]; Bertherat, J [Collaborator]; Gaillard, S [Collaborator]; Karavitaki, N [Collaborator]; Ahmed, S [Collaborator]; Unger, N [Collaborator]; Kreitschmann-Andermahr, I [Collaborator]; Gaztambide, S [Collaborator]; Pomposo, I [Collaborator]; Gan, H-W [Collaborator]; Dorward, N [Collaborator]; Fliers, E [Collaborator]; Hoogmoed, J [Collaborator]; Scaroni, C [Collaborator]; Denaro, L [Collaborator]; Nordenström, A [Collaborator]; Olsson, M [Collaborator]; Zilaitiene, B [Collaborator]; Tamašauskas, A [Collaborator]; Persani, L [Collaborator]; Lasio, G [Collaborator]; Maiter, D [Collaborator]; Raftopoulos, C [Collaborator]; Volke, V [Collaborator]; Rätsep, T [Collaborator]; Matarazzo, P [Collaborator]; Peretta, P [Collaborator]; Deutschbein, T [Collaborator]; Perez, J [Collaborator]; Zucchini, S [Collaborator]; Mazzatenta, D [Collaborator]; Grottoli, S [Collaborator]; Zenga, F [Collaborator]; Devuyst, F [Collaborator]; De Witte, O [Collaborator]; Gatto, F [Collaborator]; Rossi, D [Collaborator]; Schilbach, K [Collaborator]; Rachinger, W [Collaborator]; Beckers, A [Collaborator]; Martin, D [Collaborator]; Al-Mrayat, M [Collaborator]; Mathad, N [Collaborator]; Neggers, S J C M M [Collaborator]; Dallenga, A H G [Collaborator]; Lebl, J [Collaborator]; Tichy, M [Collaborator]; Reincke, M M [Collaborator]; van de Ven, A C [Collaborator]; van Lindert, E [Collaborator]; Kotnik, P [Collaborator]; Bošnjak, R [Collaborator]; Biagetti, B [Collaborator]; Cordero, E [Collaborator]; Colao, A [Collaborator]; Cappabianca, P [Collaborator]; Schopohl, J [Collaborator]
The European Reference Network on Rare Endocrine Conditions (Endo-ERN) aims to organize
high-quality healthcare throughout Europe, including care for pituitary adenoma patients.
As surgery is the mainstay of treatment, we aimed to describe the current surgical
practice and published surgical outcomes of pituitary adenoma within Endo-ERN.Systematic
review and meta-analysis of studies reporting surgical outcomes of pituitary adenoma
patients within Endo-ERN MTG6 pituitary reference centers between 2010 and 2019. A
survey was completed by reference centers on their current surgical practice.A total
of 18 out of 43 (42%) reference centers located in 7 of the 20 (35%) MTG6-represented
countries published 48 articles. Remission rates were 50% (95% CI: 42-59) for patients
with acromegaly, 68% (95% CI: 60-75) for Cushing's disease, and 53% (95% CI: 39-66%)
for prolactinoma. Gross total resection was achieved in 49% (95% CI: 37-61%) of patients
and visual improvement in 78% (95% CI: 68-87). Mortality, hemorrhage, and carotid
injury occurred in less than 1% of patients. New-onset hypopituitarism occurred in
16% (95% CI: 11-23), transient diabetes insipidus in 12% (95% CI: 6-21), permanent
diabetes insipidus in 4% (95% CI: 3-6), syndrome of inappropriate secretion of antidiuretic
hormone (SIADH) in 9% (95% CI: 5-14), severe epistaxis in 2% (95% CI: 0-4), and cerebrospinal
fluid leak in 4% (95% CI: 2-6). Thirty-five (81%) centers completed the survey: 54%
were operated endoscopically and 57% were together with an ENT surgeon.The results
of this study could be used as a first benchmark for the outcomes of pituitary adenoma
surgery within Endo-ERN. However, the heterogeneity between studies in the reporting
of outcomes hampers comparability and warrants outcome collection through registries.
