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Defining benchmark outcomes for transsphenoidal surgery of pituitary adenomas: a multicenter analysis

Standard

Defining benchmark outcomes for transsphenoidal surgery of pituitary adenomas: a multicenter analysis. / Drexler, Richard; Rotermund, Roman; Smith, Timothy R; Kilgallon, John L; Honegger, Jürgen; Nasi-Kordhishti, Isabella; Gardner, Paul A; Gersey, Zachary C; Abdallah, Hussein M; Jane, John A; Marino, Alexandria C; Knappe, Ulrich J; Uksul, Nesrin; Rzaev, Jamil A; Galushko, Evgeniy V; Gormolysova, Ekaterina V; Bervitskiy, Anatoliy V; Schroeder, Henry W S; Eördögh, Márton; Losa, Marco; Mortini, Pietro; Gerlach, Rüdiger; Azab, Mohammed; Budohoski, Karol P; Rennert, Robert C; Karsy, Michael; Couldwell, William T; Antunes, Apio C M; Westphal, Manfred; Ricklefs, Franz L; Flitsch, Jörg.

in: EUR J ENDOCRINOL, Jahrgang 189, Nr. 3, 01.09.2023, S. 379-386.

Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung

Harvard

Drexler, R, Rotermund, R, Smith, TR, Kilgallon, JL, Honegger, J, Nasi-Kordhishti, I, Gardner, PA, Gersey, ZC, Abdallah, HM, Jane, JA, Marino, AC, Knappe, UJ, Uksul, N, Rzaev, JA, Galushko, EV, Gormolysova, EV, Bervitskiy, AV, Schroeder, HWS, Eördögh, M, Losa, M, Mortini, P, Gerlach, R, Azab, M, Budohoski, KP, Rennert, RC, Karsy, M, Couldwell, WT, Antunes, ACM, Westphal, M, Ricklefs, FL & Flitsch, J 2023, 'Defining benchmark outcomes for transsphenoidal surgery of pituitary adenomas: a multicenter analysis', EUR J ENDOCRINOL, Jg. 189, Nr. 3, S. 379-386. https://doi.org/10.1093/ejendo/lvad124

APA

Drexler, R., Rotermund, R., Smith, T. R., Kilgallon, J. L., Honegger, J., Nasi-Kordhishti, I., Gardner, P. A., Gersey, Z. C., Abdallah, H. M., Jane, J. A., Marino, A. C., Knappe, U. J., Uksul, N., Rzaev, J. A., Galushko, E. V., Gormolysova, E. V., Bervitskiy, A. V., Schroeder, H. W. S., Eördögh, M., ... Flitsch, J. (2023). Defining benchmark outcomes for transsphenoidal surgery of pituitary adenomas: a multicenter analysis. EUR J ENDOCRINOL, 189(3), 379-386. https://doi.org/10.1093/ejendo/lvad124

Vancouver

Drexler R, Rotermund R, Smith TR, Kilgallon JL, Honegger J, Nasi-Kordhishti I et al. Defining benchmark outcomes for transsphenoidal surgery of pituitary adenomas: a multicenter analysis. EUR J ENDOCRINOL. 2023 Sep 1;189(3):379-386. https://doi.org/10.1093/ejendo/lvad124

Bibtex

@article{1efbafd7476d4636a300dfe388fb64a1,
title = "Defining benchmark outcomes for transsphenoidal surgery of pituitary adenomas: a multicenter analysis",
abstract = "IMPORTANCE: Benchmarks aid in improve outcomes for surgical procedures. However, best achievable results that have been validated internationally for transsphenoidal surgery (TS) are not available.OBJECTIVE: We aimed to establish standardized outcome benchmarks for TS of pituitary adenomas.DESIGN: A total of 2685 transsphenoidal tumor resections from 9 expert centers in 3 continents were analyzed.SETTING: Patients were risk stratified, and the median values of each center's outcomes were established. The benchmark was defined as the 75th percentile of all median values for a particular outcome. The postoperative benchmark outcomes included surgical factors, endocrinology-specific values, and neurology-specific values.RESULTS: Of 2685 patients, 1149 (42.8%) defined the low-risk benchmark cohort. Within these benchmark cases, 831 (72.3%) patients underwent microscopic TS, and 308 (26.8%) patients underwent endoscopic endonasal resection. Of all tumors, 799 (29.8%) cases invaded the cavernous sinus. The postoperative complication rate was 19.6% with mortality between 0.0% and 0.8%. Benchmark cutoffs were ≤2.9% for reoperation rate, ≤1.9% for cerebrospinal fluid leak requiring intervention, and ≤15.5% for transient diabetes insipidus. At 6 months, benchmark cutoffs were calculated as follows: readmission rate: ≤6.9%, new hypopituitarism ≤6.0%, and tumor remnant ≤19.2%.CONCLUSIONS: This analysis defines benchmark values for TS targeting morbidity and mortality and represents the best outcomes in the best patients in expert centers. These cutoffs can be used to assess different centers, patient populations, and novel surgical techniques. It should be noted that the benchmark values may influence each other and must be evaluated in their own context.",
author = "Richard Drexler and Roman Rotermund and Smith, {Timothy R} and Kilgallon, {John L} and J{\"u}rgen Honegger and Isabella Nasi-Kordhishti and Gardner, {Paul A} and Gersey, {Zachary C} and Abdallah, {Hussein M} and Jane, {John A} and Marino, {Alexandria C} and Knappe, {Ulrich J} and Nesrin Uksul and Rzaev, {Jamil A} and Galushko, {Evgeniy V} and Gormolysova, {Ekaterina V} and Bervitskiy, {Anatoliy V} and Schroeder, {Henry W S} and M{\'a}rton E{\"o}rd{\"o}gh and Marco Losa and Pietro Mortini and R{\"u}diger Gerlach and Mohammed Azab and Budohoski, {Karol P} and Rennert, {Robert C} and Michael Karsy and Couldwell, {William T} and Antunes, {Apio C M} and Manfred Westphal and Ricklefs, {Franz L} and J{\"o}rg Flitsch",
note = "{\textcopyright} The Author(s) 2023. Published by Oxford University Press on behalf of European Society of Endocrinology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.",
year = "2023",
month = sep,
day = "1",
doi = "10.1093/ejendo/lvad124",
language = "English",
volume = "189",
pages = "379--386",
journal = "EUR J ENDOCRINOL",
issn = "0804-4643",
publisher = "BioScientifica Ltd.",
number = "3",

}

RIS

TY - JOUR

T1 - Defining benchmark outcomes for transsphenoidal surgery of pituitary adenomas: a multicenter analysis

AU - Drexler, Richard

AU - Rotermund, Roman

AU - Smith, Timothy R

AU - Kilgallon, John L

AU - Honegger, Jürgen

AU - Nasi-Kordhishti, Isabella

AU - Gardner, Paul A

AU - Gersey, Zachary C

AU - Abdallah, Hussein M

AU - Jane, John A

AU - Marino, Alexandria C

AU - Knappe, Ulrich J

AU - Uksul, Nesrin

AU - Rzaev, Jamil A

AU - Galushko, Evgeniy V

AU - Gormolysova, Ekaterina V

AU - Bervitskiy, Anatoliy V

AU - Schroeder, Henry W S

AU - Eördögh, Márton

AU - Losa, Marco

AU - Mortini, Pietro

AU - Gerlach, Rüdiger

AU - Azab, Mohammed

AU - Budohoski, Karol P

AU - Rennert, Robert C

AU - Karsy, Michael

AU - Couldwell, William T

AU - Antunes, Apio C M

AU - Westphal, Manfred

AU - Ricklefs, Franz L

AU - Flitsch, Jörg

N1 - © The Author(s) 2023. Published by Oxford University Press on behalf of European Society of Endocrinology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

PY - 2023/9/1

Y1 - 2023/9/1

N2 - IMPORTANCE: Benchmarks aid in improve outcomes for surgical procedures. However, best achievable results that have been validated internationally for transsphenoidal surgery (TS) are not available.OBJECTIVE: We aimed to establish standardized outcome benchmarks for TS of pituitary adenomas.DESIGN: A total of 2685 transsphenoidal tumor resections from 9 expert centers in 3 continents were analyzed.SETTING: Patients were risk stratified, and the median values of each center's outcomes were established. The benchmark was defined as the 75th percentile of all median values for a particular outcome. The postoperative benchmark outcomes included surgical factors, endocrinology-specific values, and neurology-specific values.RESULTS: Of 2685 patients, 1149 (42.8%) defined the low-risk benchmark cohort. Within these benchmark cases, 831 (72.3%) patients underwent microscopic TS, and 308 (26.8%) patients underwent endoscopic endonasal resection. Of all tumors, 799 (29.8%) cases invaded the cavernous sinus. The postoperative complication rate was 19.6% with mortality between 0.0% and 0.8%. Benchmark cutoffs were ≤2.9% for reoperation rate, ≤1.9% for cerebrospinal fluid leak requiring intervention, and ≤15.5% for transient diabetes insipidus. At 6 months, benchmark cutoffs were calculated as follows: readmission rate: ≤6.9%, new hypopituitarism ≤6.0%, and tumor remnant ≤19.2%.CONCLUSIONS: This analysis defines benchmark values for TS targeting morbidity and mortality and represents the best outcomes in the best patients in expert centers. These cutoffs can be used to assess different centers, patient populations, and novel surgical techniques. It should be noted that the benchmark values may influence each other and must be evaluated in their own context.

AB - IMPORTANCE: Benchmarks aid in improve outcomes for surgical procedures. However, best achievable results that have been validated internationally for transsphenoidal surgery (TS) are not available.OBJECTIVE: We aimed to establish standardized outcome benchmarks for TS of pituitary adenomas.DESIGN: A total of 2685 transsphenoidal tumor resections from 9 expert centers in 3 continents were analyzed.SETTING: Patients were risk stratified, and the median values of each center's outcomes were established. The benchmark was defined as the 75th percentile of all median values for a particular outcome. The postoperative benchmark outcomes included surgical factors, endocrinology-specific values, and neurology-specific values.RESULTS: Of 2685 patients, 1149 (42.8%) defined the low-risk benchmark cohort. Within these benchmark cases, 831 (72.3%) patients underwent microscopic TS, and 308 (26.8%) patients underwent endoscopic endonasal resection. Of all tumors, 799 (29.8%) cases invaded the cavernous sinus. The postoperative complication rate was 19.6% with mortality between 0.0% and 0.8%. Benchmark cutoffs were ≤2.9% for reoperation rate, ≤1.9% for cerebrospinal fluid leak requiring intervention, and ≤15.5% for transient diabetes insipidus. At 6 months, benchmark cutoffs were calculated as follows: readmission rate: ≤6.9%, new hypopituitarism ≤6.0%, and tumor remnant ≤19.2%.CONCLUSIONS: This analysis defines benchmark values for TS targeting morbidity and mortality and represents the best outcomes in the best patients in expert centers. These cutoffs can be used to assess different centers, patient populations, and novel surgical techniques. It should be noted that the benchmark values may influence each other and must be evaluated in their own context.

U2 - 10.1093/ejendo/lvad124

DO - 10.1093/ejendo/lvad124

M3 - SCORING: Journal article

C2 - 37668325

VL - 189

SP - 379

EP - 386

JO - EUR J ENDOCRINOL

JF - EUR J ENDOCRINOL

SN - 0804-4643

IS - 3

ER -