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Endocrine Gland Neoplasms

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Brain Neoplasms

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Nervous System Neoplasms

Patients underwent transnasal approach or craniotomy approach; Patients underwent an initial surgery and a sencond staged surgery several months after the initial surgery

Patients underwent a combined approach using transnasal approach and craniotomy approach simultaneously

Two different approaches

Nan Wu

Yan Xiaorong

Liangzhao Chu

Chiyuan Ma

Wei Gao

Hui Ma

Meng Li

Nidan Qiao

Yunke Bi

Yifeng Miao

Wenlong Tang

Wenxiong Wang

Xingli Deng

The surgical treatment strategy for giant invasive pituitary adenoma is one of the current hot spots in the field of clinical research on pituitary adenoma. A comprehensive literature search resulted in numerous previous studies to investigate the efficacy, advantages and disadvantages of different surgical options.

A single approach (transnasal or craniotomy) is theoretically less invasive and has a shorter hospital stay for the patient, but may result in postoperative bleeding due to residual tumor and damage to the intracranial vessels adhering to the tumor.

The advantage of the combined approach is that the tumor can be removed to the greatest extent possible. In addition, postoperative suprasellar hemorrhage can be prevented by careful hemostasis or intracranial drainage by the transcranial team if necessary. In this way, the risk of postoperative bleeding due to residual tumor can be significantly reduced.

In some cases, waiting a few months after the initial surgery for a second-stage procedure may also be an option when the patient's condition does not allow for a combined access procedure, when the tumor is hard, or when the blood preparation is insufficient. However, staged surgery increases the financial burden on the patient, and local scar formation may make second-stage surgery more difficult and decrease the likelihood of endocrine remission of functional pituitary tumors.

Given the complexity of the treatment of giant invasive pituitary adenoma, there is a need to conduct studies comparing the combined transnasal cranial approach, the single access transnasal or cranial approach, and the staged approach simultaneously to assess whether the combined transnasal cranial approach is superior to the single access transnasal or cranial approach or the staged approach in improving the tumor resection rate in giant invasive pituitary adenoma.

Comparative Effectiveness of Different Surgical Approaches for Giant Pituitary Adenomas

Proportion of Participants with hemorrage, infection or cranial nerve defect

Ranged from 0 to 100, the higher scores mean a better outcome

Huashan Hospital

Prof

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization	Link
Comparative Effectiveness of Different Surgical Approaches for Giant Pituitary Adenomas	NCT05448690	Surgery Pituitary Adeno...	Two different a...	6 Years - 85 Years	Huashan Hospital
Comparative Effectiveness of Different Surgical Approaches for Giant Pituitary Adenomas	NCT05448690	Surgery Pituitary Adeno...	Two different a...	6 Years - 85 Years	Huashan Hospital

Spots Global Cancer Trial Database for two different approaches