Guidelines

Congress of Neurological Surgeons Systematic Review and Evidence-Based Guideline on Posttreatment Follow-up Evaluation of Patients with Nonfunctioning Pituitary Adenomas

Mateo Ziu, Ian F. Dunn, Christopher Hess, Maria Fleseriu, Mary E. Bodach, Luis M. Tumialan, Nelson M. Oyesiku, Kunal S. Patel, Renzhi Wang, Bob S. Carter, James Y. Chen, Clark C. Chen, Chirag G. Patil, Zachary Litvack, Gabriel Zada, Manish K. Aghi

Research output: Contribution to journalReview article

8 Citations (Scopus)

Abstract

BACKGROUND: Nonfunctioning pituitary adenomas (NFPAs) are the most frequent pituitary tumors. Due to the lack of hormonal hypersecretion, posttreatment follow-up evaluation of NFPAs is challenging. OBJECTIVE: To create evidence-based guidelines in an attempt to formulate guidance for posttreatment follow-up in a consistent, rigorous, and cost-effective way. METHODS: An extensive literature search was performed. Only clinical articles describing postoperative follow-up of adult patients with NFPAs were included. To ascertain the class of evidence for the posttreatment follow-ups, the authors used the Clinical Assessment evidence-based classification. RESULTS: Twenty-three studies met the inclusion criteria with respect to answering the questions on the posttreatment radiologic, endocrinologic, and ophthalmologic follow-up. Through this search, the authors formulated evidence-based guidelines for radiologic, endocrinologic, and ophthalmologic follow-up after surgical and/or radiation treatment. CONCLUSION: Long-term radiologic, endocrinologic, and ophthalmologic surveillance monitoring after surgical and/or radiation therapy treatment of NFPAs to evaluate for tumor recurrence or regrowth, as well as pituitary and visual status, is recommended. There is insufficient evidence to make a recommendation on the duration of time of surveillance and its frequency. It is recommended that the first radiologic study to evaluate the extent of resection of the NFPA be performed ≥3 months after surgical intervention. The full guidelines document for this chapter can be located at https://www.cns.org/guidelines/guidelines-management-patients-non-functioning-pituitary-adenomas/Chapter-8.

Original languageEnglish (US)
Pages (from-to)E541-E543
JournalNeurosurgery
Volume79
Issue number4
DOIs
StatePublished - Oct 1 2016

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Pituitary Neoplasms
Guidelines
Radiotherapy
Radiation
Costs and Cost Analysis
Recurrence
Therapeutics
Neoplasms

Keywords

  • Endocrine
  • Imaging
  • Nonfunctioning pituitary adenomas
  • Postoperative

Cite this

Guidelines : Congress of Neurological Surgeons Systematic Review and Evidence-Based Guideline on Posttreatment Follow-up Evaluation of Patients with Nonfunctioning Pituitary Adenomas. / Ziu, Mateo; Dunn, Ian F.; Hess, Christopher; Fleseriu, Maria; Bodach, Mary E.; Tumialan, Luis M.; Oyesiku, Nelson M.; Patel, Kunal S.; Wang, Renzhi; Carter, Bob S.; Chen, James Y.; Chen, Clark C.; Patil, Chirag G.; Litvack, Zachary; Zada, Gabriel; Aghi, Manish K.

In: Neurosurgery, Vol. 79, No. 4, 01.10.2016, p. E541-E543.

Research output: Contribution to journalReview article

Ziu, M, Dunn, IF, Hess, C, Fleseriu, M, Bodach, ME, Tumialan, LM, Oyesiku, NM, Patel, KS, Wang, R, Carter, BS, Chen, JY, Chen, CC, Patil, CG, Litvack, Z, Zada, G & Aghi, MK 2016, 'Guidelines: Congress of Neurological Surgeons Systematic Review and Evidence-Based Guideline on Posttreatment Follow-up Evaluation of Patients with Nonfunctioning Pituitary Adenomas', Neurosurgery, vol. 79, no. 4, pp. E541-E543. https://doi.org/10.1227/NEU.0000000000001392
Ziu, Mateo ; Dunn, Ian F. ; Hess, Christopher ; Fleseriu, Maria ; Bodach, Mary E. ; Tumialan, Luis M. ; Oyesiku, Nelson M. ; Patel, Kunal S. ; Wang, Renzhi ; Carter, Bob S. ; Chen, James Y. ; Chen, Clark C. ; Patil, Chirag G. ; Litvack, Zachary ; Zada, Gabriel ; Aghi, Manish K. / Guidelines : Congress of Neurological Surgeons Systematic Review and Evidence-Based Guideline on Posttreatment Follow-up Evaluation of Patients with Nonfunctioning Pituitary Adenomas. In: Neurosurgery. 2016 ; Vol. 79, No. 4. pp. E541-E543.
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AU - Dunn, Ian F.

AU - Hess, Christopher

AU - Fleseriu, Maria

AU - Bodach, Mary E.

AU - Tumialan, Luis M.

AU - Oyesiku, Nelson M.

AU - Patel, Kunal S.

AU - Wang, Renzhi

AU - Carter, Bob S.

AU - Chen, James Y.

AU - Chen, Clark C.

AU - Patil, Chirag G.

AU - Litvack, Zachary

AU - Zada, Gabriel

AU - Aghi, Manish K.

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N2 - BACKGROUND: Nonfunctioning pituitary adenomas (NFPAs) are the most frequent pituitary tumors. Due to the lack of hormonal hypersecretion, posttreatment follow-up evaluation of NFPAs is challenging. OBJECTIVE: To create evidence-based guidelines in an attempt to formulate guidance for posttreatment follow-up in a consistent, rigorous, and cost-effective way. METHODS: An extensive literature search was performed. Only clinical articles describing postoperative follow-up of adult patients with NFPAs were included. To ascertain the class of evidence for the posttreatment follow-ups, the authors used the Clinical Assessment evidence-based classification. RESULTS: Twenty-three studies met the inclusion criteria with respect to answering the questions on the posttreatment radiologic, endocrinologic, and ophthalmologic follow-up. Through this search, the authors formulated evidence-based guidelines for radiologic, endocrinologic, and ophthalmologic follow-up after surgical and/or radiation treatment. CONCLUSION: Long-term radiologic, endocrinologic, and ophthalmologic surveillance monitoring after surgical and/or radiation therapy treatment of NFPAs to evaluate for tumor recurrence or regrowth, as well as pituitary and visual status, is recommended. There is insufficient evidence to make a recommendation on the duration of time of surveillance and its frequency. It is recommended that the first radiologic study to evaluate the extent of resection of the NFPA be performed ≥3 months after surgical intervention. The full guidelines document for this chapter can be located at https://www.cns.org/guidelines/guidelines-management-patients-non-functioning-pituitary-adenomas/Chapter-8.

AB - BACKGROUND: Nonfunctioning pituitary adenomas (NFPAs) are the most frequent pituitary tumors. Due to the lack of hormonal hypersecretion, posttreatment follow-up evaluation of NFPAs is challenging. OBJECTIVE: To create evidence-based guidelines in an attempt to formulate guidance for posttreatment follow-up in a consistent, rigorous, and cost-effective way. METHODS: An extensive literature search was performed. Only clinical articles describing postoperative follow-up of adult patients with NFPAs were included. To ascertain the class of evidence for the posttreatment follow-ups, the authors used the Clinical Assessment evidence-based classification. RESULTS: Twenty-three studies met the inclusion criteria with respect to answering the questions on the posttreatment radiologic, endocrinologic, and ophthalmologic follow-up. Through this search, the authors formulated evidence-based guidelines for radiologic, endocrinologic, and ophthalmologic follow-up after surgical and/or radiation treatment. CONCLUSION: Long-term radiologic, endocrinologic, and ophthalmologic surveillance monitoring after surgical and/or radiation therapy treatment of NFPAs to evaluate for tumor recurrence or regrowth, as well as pituitary and visual status, is recommended. There is insufficient evidence to make a recommendation on the duration of time of surveillance and its frequency. It is recommended that the first radiologic study to evaluate the extent of resection of the NFPA be performed ≥3 months after surgical intervention. The full guidelines document for this chapter can be located at https://www.cns.org/guidelines/guidelines-management-patients-non-functioning-pituitary-adenomas/Chapter-8.

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