دورية أكاديمية
Radiological Knosp, Revised-Knosp, and Hardy–Wilson Classifications for the Prediction of Surgical Outcomes in the Endoscopic Endonasal Surgery of Pituitary Adenomas: Study of 228 Cases
| العنوان: | Radiological Knosp, Revised-Knosp, and Hardy–Wilson Classifications for the Prediction of Surgical Outcomes in the Endoscopic Endonasal Surgery of Pituitary Adenomas: Study of 228 Cases |
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| المؤلفون: | Marta Araujo-Castro, Alberto Acitores Cancela, Carlos Vior, Eider Pascual-Corrales, Víctor Rodríguez Berrocal |
| المصدر: | Frontiers in Oncology, Vol 11 (2022) |
| بيانات النشر: | Frontiers Media S.A. |
| سنة النشر: | 2022 |
| المجموعة: | Directory of Open Access Journals: DOAJ Articles |
| مصطلحات موضوعية: | pituitary adenomas, invasive pituitary adenomas, Knosp classification, Hardy-Wilson classification, endoscopic endonasal transsphenoidal surgery, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282 |
| الوصف: | PurposeTo evaluate which radiological classification, Knosp, revised-Knosp, or Hardy–Wilson classification, is better for the prediction of surgical outcomes in the endoscopic endonasal transsphenoidal (EET) surgery of pituitary adenomas (PAs).MethodsThis is a retrospective study of patients with PAs who underwent EET PA resection for the first time between January 2009 and December 2020. Radiological cavernous sinus invasiveness was defined as a Knosp or revised-Knosp grade >2 or a grade E in the Hardy–Wilson classification.ResultsA total of 228 patients with PAs were included. Cavernous sinus invasion was evident in 35.1% and suprasellar extension was evident in 74.6%. Overall, surgical cure was achieved in 64.3% of patients. Surgical cure was lower in invasive PAs than in non-invasive PAs (28.8% vs. 83.1%, p < 0.0001), and the risk of major complications was higher (13.8% vs. 3.4%, p = 0.003). The rate of surgical cure decreased as the grade of Knosp increased (p < 0.001), whereas the risk of complications increased (p < 0.001). Patients with Knosp 3B PAs tended to achieve surgical cure less commonly than Knosp 3A PAs (30.0% vs. 56.0%, p = 0.164). Similar results were observed based on the invasion and extension of Hardy–Wilson classification (stage A–C 83.1% vs. E 28.8% p < 0.0001, grade 0–II 81.1% vs. III–IV 59.7% p = 0.008). The Knosp classification offered the greatest diagnostic accuracy for the prediction of surgical cure (AUC 0.820), whereas the invasion Hardy–Wilson classification lacked utility for this purpose (AUC 0.654).ConclusionThe Knosp classifications offer a good orientation for the estimation of surgical cure and the risk of complications in patients with PAs submitted to EET surgery. However, the invasion Hardy–Wilson scale lacks utility for this purpose. |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| تدمد: | 2234-943X |
| العلاقة: | https://www.frontiersin.org/articles/10.3389/fonc.2021.807040/fullTest; https://doaj.org/toc/2234-943XTest; https://doaj.org/article/4239e2a30e5f4dc99ba2fcf43fbb464bTest |
| DOI: | 10.3389/fonc.2021.807040 |
| الإتاحة: | https://doi.org/10.3389/fonc.2021.807040Test https://doaj.org/article/4239e2a30e5f4dc99ba2fcf43fbb464bTest |
| رقم الانضمام: | edsbas.F5E22FE5 |
| قاعدة البيانات: | BASE |
Full Text Finder | تدمد: | 2234943X |
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| DOI: | 10.3389/fonc.2021.807040 |