000266959 001__ 266959
000266959 005__ 20190626095222.0
000266959 022__ $$a1386-341X
000266959 022__ $$a1573-7403
000266959 02470 $$a000458464100010$$2isi
000266959 0247_ $$a10.1007/s11102-018-0921-3$$2doi
000266959 037__ $$aARTICLE
000266959 245__ $$aThyrotropin-secreting pituitary adenomas: a systematic review and meta-analysis of postoperative outcomes and management
000266959 260__ $$c2019$$aNew York$$bSPRINGER
000266959 269__ $$a2019-02-01
000266959 336__ $$aReviews
000266959 520__ $$aPurposeTSH-secreting pituitary adenomas are rare pituitary tumors. An efficient treatment is essential to limit the mortality and morbidity in untreated patients. The aim of this study is to summarize the evidence about the postoperative outcomes and management of this rare pathology.MethodsA systematic search and meta-analysis of surgical series was performed.ResultsOur analysis included 23 articles (536 patients). No sex difference was observed and mean age at diagnosis was 45years. Hyperthyroidism was reportedly clinical in 67% and biochemical in 90% of patients. Co-secretion of other pituitary hormones was present in 42% of cases. Macroadenomas were found in 79% of patients, showing in 44% and 30% of cases respectively extrasellar extension and cavernous sinus invasion. The pooled rate of postoperative biochemical remission was 69.7% and a gross total resection (GTR) was observed in 54% of patients. The extent of resection was significantly increased in microadenomas (p<0.001) and cavernous sinus invasion was predictive of lower GTR rate (p<0.001). A biochemical remission was achieved in 66% of patients after adjuvant radiation therapy and in 76% after adjuvant medical treatment. The combination of both allowed remission in 67% of cases. At final follow-up the overall biochemical remission rate was significantly improved (85.8%) when compared to the postoperative biochemical remission (p<0.001).ConclusionWhen compared to the early postoperative period, at last follow-up biochemical remission was significantly greater (p<0.001). GTR was achieved in half of patients; the size of tumor and cavernous sinus invasion determined the extent of resection.
000266959 650__ $$aEndocrinology & Metabolism
000266959 650__ $$aEndocrinology & Metabolism
000266959 6531_ $$aendoscopy
000266959 6531_ $$apituitary adenoma
000266959 6531_ $$asitsh
000266959 6531_ $$athyrotropin secreting adenoma
000266959 6531_ $$atranssphenoidal
000266959 6531_ $$atsh-secreting adenoma
000266959 6531_ $$acavernous sinus space
000266959 6531_ $$athyroid-hormone
000266959 6531_ $$asingle-center
000266959 6531_ $$atranssphenoidal surgery
000266959 6531_ $$asomatostatin analogs
000266959 6531_ $$afollow-up
000266959 6531_ $$ainappropriate secretion
000266959 6531_ $$asurgical-treatment
000266959 6531_ $$atsh
000266959 6531_ $$adiagnosis
000266959 700__ $$aCossu, Giulia
000266959 700__ $$aDaniel, Roy Thomas
000266959 700__ $$aPierzchala, Katarzyna$$0244833$$g174355
000266959 700__ $$aBerhouma, Moncef
000266959 700__ $$aPitteloud, Nelly
000266959 700__ $$aLamine, Faiza
000266959 700__ $$aColao, Annamaria
000266959 700__ $$aMesserer, Mahmoud
000266959 773__ $$k1$$j22$$q79-88$$tPituitary
000266959 8560_ $$frolf.gruetter@epfl.ch
000266959 909C0 $$zPasquier, Simon$$0252276$$yApproved$$pLIFMET$$xU10984$$mrolf.gruetter@epfl.ch
000266959 909CO $$pSB$$ooai:infoscience.epfl.ch:266959$$preview
000266959 961__ $$abeatrice.marselli@epfl.ch
000266959 973__ $$aEPFL$$sPUBLISHED$$rREVIEWED
000266959 980__ $$aREVIEW
000266959 980__ $$aWoS
000266959 981__ $$aoverwrite