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Table 1 Characteristics and post-operative outcomes of surgical naïve patients (Group A) undergoing endoscopic TSS

From: Post-operative volumes following endoscopic surgery for non-functioning pituitary macroadenomas are predictive of further intervention, but not endocrine outcomes

Characteristics Values
N 159
Gender M: 97 (61.0%); F: 62 (39.0%)
Mean age at surgery (years) 59.3 ± 13.3; Range = 21-87 years
Presentation
 • Loss of vision 90 (56.6%)
 • Incidental (Asymptomatic) 27 (17.0%)
 • Symptoms of hypopituitarism 18 (11.3%); (8-Hypogonadism)
 • Headaches 13 (8.2%)
 • Apoplexy 9 (5.7%)
 • CN palsy 2 (1.3%)
Emergency 8 (6- apoplexy, 1-visual loss, 1-CN palsy)
Indication for surgery
 • Visual field defect 104 (65.4%)
 • Contact with optic chiasm/ suprasellar extension (sight-threatening) 33 (20.8%)
 • Apoplexy 9 (5.7%)
 • Large tumour volume 6 (3.8%)
 • Enlarging tumour on surveillance 4 (2.5%)
 • CN involvement 3 (1.9%)
Immunohistochemistry
 • Gonadotroph 84 (52.8%)
 • Null Cell 52 (32.7%)
 • Plurihormonal adenoma 3 (1.9%)
 • Silent corticotroph adenoma 8 (5.0%)
 • Silent thyrotroph adenoma 1 (0.6%)
 • Silent somatotroph adenoma 1 (0.6%)
 • Silent lactotroph adenoma 1 (0.6%)
 • Hyperplasia 1 (0.6%)
 • Other (necrotic, infarcted, normal, no tissue) 8 (5.0%)
Post-surgical outcomesa
Endocrinopathies At diagnosis (n=101) Post-operative (n=101)
  • Normal pituitary function 24 (23.8%) 20 (19.8%)
  • 1-2 anterior pituitary axis deficits 41 (40.6%) 43 (42.6%)
  • ≥ 3 anterior pituitary axis deficits 36 (35.6%) 38 (37.6%)
  • ADH deficiency 0 2 (2.0%) + 2 transient DI
Individual pituitary axis At diagnosis (n=101) Post-operative (n=101)
  • GH deficiency 60 (59.4%) 71 (70.3%)
  • LH/ FSH deficiency 55 (54.5%) 56 (55.4%)
  • ACTH deficiency 33 (32.7%) 37 (36.6%)
  • TSH deficiency 36 (35.6%) 37 (36.6%)
Preserved pituitary function (n=101, total cohort) 60 (59.4%)
Pituitary axis recovery (n=77, excluding 24 patients with normal pituitary function pre-op) 16 (20.8%)
New pituitary axis dysfunction (only including patients with 0-3 anterior pituitary axes impaired pre-op, n=83) 25 (30.1%)
Tumour size
 Median tumour volume (cm3) At diagnosis (n=156) Post-operative (n=151)
5.51 IQR: 3.52 – 9.48 0.92 IQR: 0.44 – 2.02
 Extent of tumour resection (EOR), median (%), n=151 82.3%, IQR: 64.8 – 91.5%
 Gross Total Resection (GTR) 9 (6.0%)
 Near-Total Resection (≥90%) 44 (29.1%), including 9 GTR
 Subtotal Resection (75-89.9%) 53 (35.1%)
 Partial Resection (<75%) 54 (35.8%)
Long-term follow-up
 Mean Follow-up (years) 3.1 ± 2.1 years; Range 0.5-9.6 years
 Large tumour remnant, requiring intervention 14 (8.8%)
 Tumour regrowth 28 (17.6%), of which 24 (15.1%) required intervention
Further Treatment
 • Radiotherapy (RT) 35 (22.0%)
External beam RT: 25 (15.7%)
Stereotactic radiosurgery: 10 (6.3%)
 • Repeat Surgery 9 (5.7%)
Deaths 11 (6.9%)
  1. aincluding only patients with complete formal pre- and post-operative endocrine assessments (i.e. excluding 48 patients without dynamic GH stimulation tests at baseline and/or after surgery and 10 additional patients with other missing endocrine data)