Title

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

Department

Neurosurgery

Document Type

Article

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.

ABBREVIATION: NFPA, nonfunctioning pituitary adenoma.

Medical Subject Headings

Adenoma; Adult; Aftercare; Aged; Cost-Benefit Analysis; Evidence-Based Medicine; Female; Humans; Male; Middle Aged; Pituitary Neoplasms; Young Adult

Publication Date

10-1-2016

Publication Title

Neurosurgery

ISSN

1524-4040

Volume

79

Issue

4

First Page

541

Last Page

543

PubMed ID

27635964

Digital Object Identifier (DOI)

10.1227/NEU.0000000000001392

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