Outcomes of transsphenoidal surgery for pituitary adenomas in Spain: a retrospective multicenter study

Background The outcomes of transsphenoidal surgery (TSS) for pituitary adenoma (PA) depend on many factors, including the availability of an expert team and the volume of surgeries performed. Data on the outcomes of TSS for PA are scarce in our country. TESSPAIN evaluates TSS outcomes in Spanish cen...

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Autores: Paja, M, Soto, A, Hanzu, FA, Guerrero-Pérez, F, Cámara, R, Moure, D, Gálvez, A, Simó-Servat, A, Villar-Taibo, R, Calatayud, M, Vicente, A, Recio-Córdova, JM, Serra, G, Rojas-Marcos, PM, Parra-Ramírez, P, Araujo-Castro, M, Librizzi, S, Irigaray, A, Ollero, D, Aznar, S, Muñoz, F, Aulinas, A, González-Fernández, L, García-Centeno, R, Egaña, N, González-Vidal, T, Menéndez, E, Delgado, AM, Abarca, J, Sottile, J, Picó, AM, Novo, C, Ortiz, I, Tenorio, C, de León, R, de Pablos-Velasco, P, Crespo, C, Peñalver, D, Díaz-Soto, G, Puig-Domingo, M, Biagetti, B
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2025
País:España
Institución:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
Repositorio:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
OAI Identifier:oai:iibsantpau.fundanetsuite.com:p19548
Acceso en línea:https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=19548
Access Level:acceso abierto
Palabra clave:transsphenoidal surgery
pituitary adenoma
surgical complications
success rate
surgical experience
surgical specialization
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spelling Outcomes of transsphenoidal surgery for pituitary adenomas in Spain: a retrospective multicenter studyPaja, MSoto, AHanzu, FAGuerrero-Pérez, FCámara, RMoure, DGálvez, ASimó-Servat, AVillar-Taibo, RCalatayud, MVicente, ARecio-Córdova, JMSerra, GRojas-Marcos, PMParra-Ramírez, PAraujo-Castro, MLibrizzi, SIrigaray, AOllero, DAznar, SMuñoz, FAulinas, AGonzález-Fernández, LGarcía-Centeno, REgaña, NGonzález-Vidal, TMenéndez, EDelgado, AMAbarca, JSottile, JPicó, AMNovo, COrtiz, ITenorio, Cde León, Rde Pablos-Velasco, PCrespo, CPeñalver, DDíaz-Soto, GPuig-Domingo, MBiagetti, Btranssphenoidal surgerypituitary adenomasurgical complicationssuccess ratesurgical experiencesurgical specializationBackground The outcomes of transsphenoidal surgery (TSS) for pituitary adenoma (PA) depend on many factors, including the availability of an expert team and the volume of surgeries performed. Data on the outcomes of TSS for PA are scarce in our country. TESSPAIN evaluates TSS outcomes in Spanish centers to assess the influence of surgical volume and specialized neurosurgical teams on success and complication rates. Methods A retrospective, nationwide, study of Spanish centers performing TSS between January 2018 and December 2022. Centers were classified as high volume (HV) [n=11, defined as centers with recognized expertise in Spain or those performing more than 25 TSS/year] or non-HV. Data collection included surgical success rates, complications, and pituitary adenoma resectability (R-PA). Additional analyses evaluated the impact of dedicated neurosurgical teams (DNT) within HV centers. Results A total of 2815 TSS from 29 Spanish centers were included (1421 NSPA, 436 GH-secreting, 323 Cushing's disease, 127 PRL-secreting and 25 TSH-secreting PA). The overall success rate was 50.5%, 76.8% for R-PA. HV centers had a higher overall success rate (53.1 vs. 47.7%; p=0.03). Better TSS outcomes for NSPA accounted for this difference. The overall TSS complication rate was 22.1%, which was higher for NSPA than for SPA (25.0 vs. 17.7%). The overall complication rate of TSS for PA was significantly higher in non-HV centers than in HV centers (24 vs 20.4.0; p <0.01). Centers with a DNT showed a trend to higher success rate in R-PA, while having a lower overall incidence of complications in TSS for PA than HV centers without a DNT (18.5 vs. 23.0; p=0.058), mainly reducing the rate of permanent ADH deficiency in all TSS for PA (2.7 vs. 8.4%; p<0.001). Conclusion Higher surgical volume and DNT are associated with improved TSS outcomes for PA in Spain. Our results support the recommendation of concentration of pituitary surgery in a reduced number of centers of expertise in our country in order to improve the success rate and reduce complications, mainly postoperative ADH deficiency.FRONTIERS MEDIA SA2025info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=19548Frontiers in EndocrinologyISSN: 16642392reponame:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pauinstname:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)Inglésinfo:eu-repo/semantics/openAccessoai:iibsantpau.fundanetsuite.com:p195482026-06-14T12:41:47Z
dc.title.none.fl_str_mv Outcomes of transsphenoidal surgery for pituitary adenomas in Spain: a retrospective multicenter study
title Outcomes of transsphenoidal surgery for pituitary adenomas in Spain: a retrospective multicenter study
spellingShingle Outcomes of transsphenoidal surgery for pituitary adenomas in Spain: a retrospective multicenter study
Paja, M
transsphenoidal surgery
pituitary adenoma
surgical complications
success rate
surgical experience
surgical specialization
title_short Outcomes of transsphenoidal surgery for pituitary adenomas in Spain: a retrospective multicenter study
title_full Outcomes of transsphenoidal surgery for pituitary adenomas in Spain: a retrospective multicenter study
title_fullStr Outcomes of transsphenoidal surgery for pituitary adenomas in Spain: a retrospective multicenter study
title_full_unstemmed Outcomes of transsphenoidal surgery for pituitary adenomas in Spain: a retrospective multicenter study
title_sort Outcomes of transsphenoidal surgery for pituitary adenomas in Spain: a retrospective multicenter study
dc.creator.none.fl_str_mv Paja, M
Soto, A
Hanzu, FA
Guerrero-Pérez, F
Cámara, R
Moure, D
Gálvez, A
Simó-Servat, A
Villar-Taibo, R
Calatayud, M
Vicente, A
Recio-Córdova, JM
Serra, G
Rojas-Marcos, PM
Parra-Ramírez, P
Araujo-Castro, M
Librizzi, S
Irigaray, A
Ollero, D
Aznar, S
Muñoz, F
Aulinas, A
González-Fernández, L
García-Centeno, R
Egaña, N
González-Vidal, T
Menéndez, E
Delgado, AM
Abarca, J
Sottile, J
Picó, AM
Novo, C
Ortiz, I
Tenorio, C
de León, R
de Pablos-Velasco, P
Crespo, C
Peñalver, D
Díaz-Soto, G
Puig-Domingo, M
Biagetti, B
author Paja, M
author_facet Paja, M
Soto, A
Hanzu, FA
Guerrero-Pérez, F
Cámara, R
Moure, D
Gálvez, A
Simó-Servat, A
Villar-Taibo, R
Calatayud, M
Vicente, A
Recio-Córdova, JM
Serra, G
Rojas-Marcos, PM
Parra-Ramírez, P
Araujo-Castro, M
Librizzi, S
Irigaray, A
Ollero, D
Aznar, S
Muñoz, F
Aulinas, A
González-Fernández, L
García-Centeno, R
Egaña, N
González-Vidal, T
Menéndez, E
Delgado, AM
Abarca, J
Sottile, J
Picó, AM
Novo, C
Ortiz, I
Tenorio, C
de León, R
de Pablos-Velasco, P
Crespo, C
Peñalver, D
Díaz-Soto, G
Puig-Domingo, M
Biagetti, B
author_role author
author2 Soto, A
Hanzu, FA
Guerrero-Pérez, F
Cámara, R
Moure, D
Gálvez, A
Simó-Servat, A
Villar-Taibo, R
Calatayud, M
Vicente, A
Recio-Córdova, JM
Serra, G
Rojas-Marcos, PM
Parra-Ramírez, P
Araujo-Castro, M
Librizzi, S
Irigaray, A
Ollero, D
Aznar, S
Muñoz, F
Aulinas, A
González-Fernández, L
García-Centeno, R
Egaña, N
González-Vidal, T
Menéndez, E
Delgado, AM
Abarca, J
Sottile, J
Picó, AM
Novo, C
Ortiz, I
Tenorio, C
de León, R
de Pablos-Velasco, P
Crespo, C
Peñalver, D
Díaz-Soto, G
Puig-Domingo, M
Biagetti, B
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv transsphenoidal surgery
pituitary adenoma
surgical complications
success rate
surgical experience
surgical specialization
topic transsphenoidal surgery
pituitary adenoma
surgical complications
success rate
surgical experience
surgical specialization
description Background The outcomes of transsphenoidal surgery (TSS) for pituitary adenoma (PA) depend on many factors, including the availability of an expert team and the volume of surgeries performed. Data on the outcomes of TSS for PA are scarce in our country. TESSPAIN evaluates TSS outcomes in Spanish centers to assess the influence of surgical volume and specialized neurosurgical teams on success and complication rates. Methods A retrospective, nationwide, study of Spanish centers performing TSS between January 2018 and December 2022. Centers were classified as high volume (HV) [n=11, defined as centers with recognized expertise in Spain or those performing more than 25 TSS/year] or non-HV. Data collection included surgical success rates, complications, and pituitary adenoma resectability (R-PA). Additional analyses evaluated the impact of dedicated neurosurgical teams (DNT) within HV centers. Results A total of 2815 TSS from 29 Spanish centers were included (1421 NSPA, 436 GH-secreting, 323 Cushing's disease, 127 PRL-secreting and 25 TSH-secreting PA). The overall success rate was 50.5%, 76.8% for R-PA. HV centers had a higher overall success rate (53.1 vs. 47.7%; p=0.03). Better TSS outcomes for NSPA accounted for this difference. The overall TSS complication rate was 22.1%, which was higher for NSPA than for SPA (25.0 vs. 17.7%). The overall complication rate of TSS for PA was significantly higher in non-HV centers than in HV centers (24 vs 20.4.0; p <0.01). Centers with a DNT showed a trend to higher success rate in R-PA, while having a lower overall incidence of complications in TSS for PA than HV centers without a DNT (18.5 vs. 23.0; p=0.058), mainly reducing the rate of permanent ADH deficiency in all TSS for PA (2.7 vs. 8.4%; p<0.001). Conclusion Higher surgical volume and DNT are associated with improved TSS outcomes for PA in Spain. Our results support the recommendation of concentration of pituitary surgery in a reduced number of centers of expertise in our country in order to improve the success rate and reduce complications, mainly postoperative ADH deficiency.
publishDate 2025
dc.date.none.fl_str_mv 2025
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=19548
url https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=19548
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv FRONTIERS MEDIA SA
publisher.none.fl_str_mv FRONTIERS MEDIA SA
dc.source.none.fl_str_mv Frontiers in Endocrinology
ISSN: 16642392
reponame:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
instname:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
instname_str Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
reponame_str r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
collection r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
repository.name.fl_str_mv
repository.mail.fl_str_mv
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