Starting point for benchmarking outcomes and reporting of pituitary adenoma surgery within the European Reference Network on Rare Endocrine Conditions (Endo-ERN): results from a meta-analysis and survey study

Amir H Zamanipoor Najafabadi; Merel van der Meulen; MTG6 Pituitary of Endo-ERN; Ana Luisa Priego Zurita; S Faisal Ahmed; Wouter R van Furth; Evangelia Charmandari; Olaf Hiort; Alberto M Pereira; Mehul Dattani; Diana Vitali; Johan P de Graaf; Nienke R Biermasz

doi:10.1530/EC-22-0349

Starting point for benchmarking outcomes and reporting of pituitary adenoma surgery within the European Reference Network on Rare Endocrine Conditions (Endo-ERN): results from a meta-analysis and survey study

Amir H Zamanipoor Najafabadi^*, Merel van der Meulen, MTG6 Pituitary of Endo-ERN, Ana Luisa Priego Zurita, S Faisal Ahmed, Wouter R van Furth, Evangelia Charmandari, Olaf Hiort, Alberto M Pereira, Mehul Dattani, Diana Vitali, Johan P de Graaf, Nienke R Biermasz

^*Corresponding author for this work

Internal Medicine

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Objective: 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.
Design and Methods: 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.
Results: 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.
Conclusion: 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.

Original language	English
Article number	e220349
Number of pages	12
Journal	Endocrine Connections
Volume	12
Issue number	1
Early online date	13 Dec 2022
DOIs	https://doi.org/10.1530/EC-22-0349
Publication status	Published - Jan 2023

Bibliographical note

Funding Information:
This publication has been supported by Endo-ERN, which is co-funded by the European Union’s third Health Programme (CHAFEA Framework Partnership Agreement No 739527).

Publisher Copyright:
© 2022 The authors.

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This output contributes to the following UN Sustainable Development Goals (SDGs)

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Zamanipoor Najafabadi, A. H., van der Meulen, M., MTG6 Pituitary of Endo-ERN, Priego Zurita, A. L., Faisal Ahmed, S., van Furth, W. R., Charmandari, E., Hiort, O., Pereira, A. M., Dattani, M., Vitali, D., de Graaf, J. P., & Biermasz, N. R. (2023). Starting point for benchmarking outcomes and reporting of pituitary adenoma surgery within the European Reference Network on Rare Endocrine Conditions (Endo-ERN): results from a meta-analysis and survey study. Endocrine Connections, 12(1), [e220349]. https://doi.org/10.1530/EC-22-0349

@article{c6287669c8ba4ce0abf786e4a3d6aa30,

title = "Starting point for benchmarking outcomes and reporting of pituitary adenoma surgery within the European Reference Network on Rare Endocrine Conditions (Endo-ERN): results from a meta-analysis and survey study",

abstract = "Objective: The European Reference Network on Rare Endocrine Conditions (Endo-ERN)aims to organize high-quality healthcare throughout Europe, including care for pituitaryadenoma patients. As surgery is the mainstay of treatment, we aimed to describe thecurrent surgical practice and published surgical outcomes of pituitary adenoma withinEndo-ERN.Design and Methods: Systematic review and meta-analysis of studies reporting surgicaloutcomes of pituitary adenoma patients within Endo-ERN MTG6 pituitary referencecenters between 2010 and 2019. A survey was completed by reference centers on theircurrent surgical practice.Results: 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{\textquoteright}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, andcarotid injury occurred in less than 1% of patients. New-onset hypopituitarism occurredin 16% (95% CI: 11–23), transient diabetes insipidus in 12% (95% CI: 6–21), permanentdiabetes insipidus in 4% (95% CI: 3–6), syndrome of inappropriate secretion ofantidiuretic 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 thesurvey: 54% were operated endoscopically and 57% were together with an ENT surgeon.Conclusion: The results of this study could be used as a first benchmark for the outcomesof pituitary adenoma surgery within Endo-ERN. However, the heterogeneity betweenstudies in the reporting of outcomes hampers comparability and warrants outcomecollection through registries.",

author = "{Zamanipoor Najafabadi}, {Amir H} and {van der Meulen}, Merel and {MTG6 Pituitary of Endo-ERN} and {Priego Zurita}, {Ana Luisa} and {Faisal Ahmed}, S and {van Furth}, {Wouter R} and Evangelia Charmandari and Olaf Hiort and Pereira, {Alberto M} and Mehul Dattani and Diana Vitali and {de Graaf}, {Johan P} and Biermasz, {Nienke R} and _ _ and D Steenvoorden and I Bowring and {van der Klauw}, MM and RA Vergeer and M Losa and P Mortini and W Drake and J Grieve and M Didi and C Mallucci and MG Shaikh and S Hassan and JOL Jorgensen and M Albarazi and S Zaharieva and A. Hadzhiyanev and M T{\'o}th and L S{\'i}pos and D Unuane and J D'Haens and U Feldt-Rasmussen and L Poulsgaard and T Brue and H Dufour and J Bertherat and S Gaillard and N Karavitaki and S Ahmed and N Unger and I Kreitschmann-Andermahr and S Gaztambide and F Gatto and A Beckers and D Martin and SJCMM Neggers and AHG Dallenga and {van de Ven}, AC",

note = "Funding Information: This publication has been supported by Endo-ERN, which is co-funded by the European Union{\textquoteright}s third Health Programme (CHAFEA Framework Partnership Agreement No 739527). Publisher Copyright: {\textcopyright} 2022 The authors.",

year = "2023",

month = jan,

doi = "10.1530/EC-22-0349",

language = "English",

volume = "12",

journal = "Endocrine Connections",

issn = "2049-3614",

publisher = "Bioscientifica Ltd",

number = "1",

}

Zamanipoor Najafabadi, AH, van der Meulen, M, MTG6 Pituitary of Endo-ERN, Priego Zurita, AL, Faisal Ahmed, S, van Furth, WR, Charmandari, E, Hiort, O, Pereira, AM, Dattani, M, Vitali, D, de Graaf, JP & Biermasz, NR 2023, 'Starting point for benchmarking outcomes and reporting of pituitary adenoma surgery within the European Reference Network on Rare Endocrine Conditions (Endo-ERN): results from a meta-analysis and survey study', Endocrine Connections, vol. 12, no. 1, e220349. https://doi.org/10.1530/EC-22-0349

Starting point for benchmarking outcomes and reporting of pituitary adenoma surgery within the European Reference Network on Rare Endocrine Conditions (Endo-ERN): results from a meta-analysis and survey study. / Zamanipoor Najafabadi, Amir H; van der Meulen, Merel; MTG6 Pituitary of Endo-ERN et al.
In: Endocrine Connections, Vol. 12, No. 1, e220349, 01.2023.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Starting point for benchmarking outcomes and reporting of pituitary adenoma surgery within the European Reference Network on Rare Endocrine Conditions (Endo-ERN)

T2 - results from a meta-analysis and survey study

AU - Zamanipoor Najafabadi, Amir H

AU - van der Meulen, Merel

AU - MTG6 Pituitary of Endo-ERN

AU - Priego Zurita, Ana Luisa

AU - Faisal Ahmed, S

AU - van Furth, Wouter R

AU - Charmandari, Evangelia

AU - Hiort, Olaf

AU - Pereira, Alberto M

AU - Dattani, Mehul

AU - Vitali, Diana

AU - de Graaf, Johan P

AU - Biermasz, Nienke R

AU - _, _

AU - Steenvoorden, D

AU - Bowring, I

AU - van der Klauw, MM

AU - Vergeer, RA

AU - Losa, M

AU - Mortini, P

AU - Drake, W

AU - Grieve, J

AU - Didi, M

AU - Mallucci, C

AU - Shaikh, MG

AU - Hassan, S

AU - Jorgensen, JOL

AU - Albarazi, M

AU - Zaharieva, S

AU - Hadzhiyanev, A.

AU - Tóth, M

AU - Sípos, L

AU - Unuane, D

AU - D'Haens, J

AU - Feldt-Rasmussen, U

AU - Poulsgaard, L

AU - Brue, T

AU - Dufour, H

AU - Bertherat, J

AU - Gaillard, S

AU - Karavitaki, N

AU - Ahmed, S

AU - Unger, N

AU - Kreitschmann-Andermahr, I

AU - Gaztambide, S

AU - Gatto, F

AU - Beckers, A

AU - Martin, D

AU - Neggers, SJCMM

AU - Dallenga, AHG

AU - van de Ven, AC

N1 - Funding Information: This publication has been supported by Endo-ERN, which is co-funded by the European Union’s third Health Programme (CHAFEA Framework Partnership Agreement No 739527). Publisher Copyright: © 2022 The authors.

PY - 2023/1

Y1 - 2023/1

N2 - Objective: The European Reference Network on Rare Endocrine Conditions (Endo-ERN)aims to organize high-quality healthcare throughout Europe, including care for pituitaryadenoma patients. As surgery is the mainstay of treatment, we aimed to describe thecurrent surgical practice and published surgical outcomes of pituitary adenoma withinEndo-ERN.Design and Methods: Systematic review and meta-analysis of studies reporting surgicaloutcomes of pituitary adenoma patients within Endo-ERN MTG6 pituitary referencecenters between 2010 and 2019. A survey was completed by reference centers on theircurrent surgical practice.Results: 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, andcarotid injury occurred in less than 1% of patients. New-onset hypopituitarism occurredin 16% (95% CI: 11–23), transient diabetes insipidus in 12% (95% CI: 6–21), permanentdiabetes insipidus in 4% (95% CI: 3–6), syndrome of inappropriate secretion ofantidiuretic 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 thesurvey: 54% were operated endoscopically and 57% were together with an ENT surgeon.Conclusion: The results of this study could be used as a first benchmark for the outcomesof pituitary adenoma surgery within Endo-ERN. However, the heterogeneity betweenstudies in the reporting of outcomes hampers comparability and warrants outcomecollection through registries.

AB - Objective: The European Reference Network on Rare Endocrine Conditions (Endo-ERN)aims to organize high-quality healthcare throughout Europe, including care for pituitaryadenoma patients. As surgery is the mainstay of treatment, we aimed to describe thecurrent surgical practice and published surgical outcomes of pituitary adenoma withinEndo-ERN.Design and Methods: Systematic review and meta-analysis of studies reporting surgicaloutcomes of pituitary adenoma patients within Endo-ERN MTG6 pituitary referencecenters between 2010 and 2019. A survey was completed by reference centers on theircurrent surgical practice.Results: 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, andcarotid injury occurred in less than 1% of patients. New-onset hypopituitarism occurredin 16% (95% CI: 11–23), transient diabetes insipidus in 12% (95% CI: 6–21), permanentdiabetes insipidus in 4% (95% CI: 3–6), syndrome of inappropriate secretion ofantidiuretic 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 thesurvey: 54% were operated endoscopically and 57% were together with an ENT surgeon.Conclusion: The results of this study could be used as a first benchmark for the outcomesof pituitary adenoma surgery within Endo-ERN. However, the heterogeneity betweenstudies in the reporting of outcomes hampers comparability and warrants outcomecollection through registries.

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Zamanipoor Najafabadi AH, van der Meulen M, MTG6 Pituitary of Endo-ERN, Priego Zurita AL, Faisal Ahmed S, van Furth WR et al. Starting point for benchmarking outcomes and reporting of pituitary adenoma surgery within the European Reference Network on Rare Endocrine Conditions (Endo-ERN): results from a meta-analysis and survey study. Endocrine Connections. 2023 Jan;12(1):e220349. Epub 2022 Dec 13. doi: 10.1530/EC-22-0349

Starting point for benchmarking outcomes and reporting of pituitary adenoma surgery within the European Reference Network on Rare Endocrine Conditions (Endo-ERN): results from a meta-analysis and survey study

Abstract

Bibliographical note

UN SDGs

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