{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T20:56:48Z","timestamp":1791233808115,"version":"4.1.0"},"reference-count":45,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T00:00:00Z","timestamp":1774310400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100012397","name":"Army Medical University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100012397","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100011476","name":"Southwest Hospital","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100011476","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["World Neurosurgery"],"published-print":{"date-parts":[[2026,6]]},"DOI":"10.1016\/j.wneu.2026.124958","type":"journal-article","created":{"date-parts":[[2026,3,28]],"date-time":"2026-03-28T16:12:14Z","timestamp":1774714334000},"page":"124958","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"special_numbering":"C","title":["A Proposed Classification and Scoring System Predicting Gross Total Resection of Recurrent and Residual Pituitary Adenoma: A Retrospective Study"],"prefix":"10.1016","volume":"210","author":[{"given":"Wei","family":"Quan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Da-Wei","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lan","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huan-Ran","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Long","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheng-Li","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6093-9744","authenticated-orcid":false,"given":"Rong","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.wneu.2026.124958_bib1","doi-asserted-by":"crossref","first-page":"613","DOI":"10.1002\/cncr.20412","article-title":"The prevalence of pituitary adenomas: a systematic review","volume":"101","author":"Ezzat","year":"2004","journal-title":"Cancer"},{"key":"10.1016\/j.wneu.2026.124958_bib2","first-page":"419","article-title":"Comparison of clinical outcomes between microscopic and endoscopic transsphenoidal pituitary tumor resection","volume":"864","author":"Krishnakumar","year":"2025","journal-title":"J Neurol Surg B, Skull base"},{"key":"10.1016\/j.wneu.2026.124958_bib3","doi-asserted-by":"crossref","first-page":"1043","DOI":"10.1227\/01.NEU.0000119325.14116.9C","article-title":"Endoscopy and transsphenoidal surgery","volume":"54","author":"Cappabianca","year":"2004","journal-title":"Neurosurgery"},{"key":"10.1016\/j.wneu.2026.124958_bib4","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1007\/s11102-008-0094-6","article-title":"Transsphenoidal surgery","volume":"11","author":"Joshi","year":"2008","journal-title":"Pituitary"},{"key":"10.1016\/j.wneu.2026.124958_bib5","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1530\/EJE-10-0255","article-title":"Factors predicting relapse of nonfunctioning pituitary macroadenomas after neurosurgery: a study of 142 patients","volume":"163","author":"Brochier","year":"2010","journal-title":"Eur J Endocrinol"},{"key":"10.1016\/j.wneu.2026.124958_bib6","doi-asserted-by":"crossref","first-page":"2857","DOI":"10.1007\/s40618-025-02674-6","article-title":"Predictors of progression after surgery in non-functioning pituitary macroadenomas: a Spanish multicenter study","volume":"48","author":"Biagetti","year":"2025","journal-title":"J Endocrinol Invest"},{"key":"10.1016\/j.wneu.2026.124958_bib7","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1007\/s11060-025-05041-w","article-title":"Clinical characteristics and pathological features of growth hormone-secreting pituitary adenoma combined with hyperprolactinemia","volume":"174","author":"Mo","year":"2025","journal-title":"J Neurooncol"},{"key":"10.1016\/j.wneu.2026.124958_bib8","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1186\/s40478-025-02050-8","article-title":"Transcription factor-based classification of pituitary adenomas\/PitNETs: a comparative analysis and clinical implications across WHO 2004, 2017 and 2022 in 921 cases","volume":"13","author":"Nasi-Kordhishti","year":"2025","journal-title":"Acta Neuropathol Commun"},{"key":"10.1016\/j.wneu.2026.124958_bib9","doi-asserted-by":"crossref","DOI":"10.1530\/ERC-24-0186","article-title":"Clinicopathological characteristics associated with the prognosis of recurrent gonadotroph tumors","volume":"32","author":"Kaparounaki","year":"2025","journal-title":"Endocr Relat Cancer"},{"key":"10.1016\/j.wneu.2026.124958_bib10","doi-asserted-by":"crossref","first-page":"184","DOI":"10.3171\/2024.10.JNS241338","article-title":"Machine learning-based model to predict long-term tumor control and additional interventions following pituitary surgery for Cushing's disease","volume":"143","author":"Shinya","year":"2025","journal-title":"J Neurosurg"},{"key":"10.1016\/j.wneu.2026.124958_bib11","doi-asserted-by":"crossref","first-page":"R45","DOI":"10.1093\/ejendo\/lvaf100","article-title":"Revised European Society of Endocrinology Clinical Practice Guideline for the management of aggressive pituitary tumours and pituitary carcinomas","volume":"192","author":"Raverot","year":"2025","journal-title":"Eur J Endocrinol"},{"key":"10.1016\/j.wneu.2026.124958_bib12","doi-asserted-by":"crossref","DOI":"10.1016\/j.clineuro.2025.109023","article-title":"Early adjuvant radiation reduces the rate of recurrence following surgery for silent corticotroph pituitary neuroendocrine tumors","volume":"256","author":"Goyal-Honavar","year":"2025","journal-title":"Clin Neurol Neurosurg"},{"key":"10.1016\/j.wneu.2026.124958_bib13","doi-asserted-by":"crossref","first-page":"5203","DOI":"10.3390\/jcm14155203","article-title":"Management of recurrent and aggressive non-functioning pituitary adenomas","volume":"14","author":"Hefner","year":"2025","journal-title":"J Clin Med"},{"key":"10.1016\/j.wneu.2026.124958_bib14","doi-asserted-by":"crossref","first-page":"1589","DOI":"10.1007\/s40618-025-02564-x","article-title":"Repeat gamma knife radiosurgery for recurrent pituitary adenomas","volume":"48","author":"Losa","year":"2025","journal-title":"J Endocrinol Invest"},{"key":"10.1016\/j.wneu.2026.124958_bib15","doi-asserted-by":"crossref","first-page":"892","DOI":"10.1227\/neu.0000000000003174","article-title":"Long-term outcomes after CyberKnife radiosurgery for nonfunctioning pituitary adenomas","volume":"96","author":"Wei","year":"2025","journal-title":"Neurosurgery"},{"key":"10.1016\/j.wneu.2026.124958_bib16","doi-asserted-by":"crossref","first-page":"257","DOI":"10.4103\/neurol-india.Neurol-India-D-24-00110","article-title":"Tumor control and long-term survival in non-functional pituitary adenoma treated with adjuvant radiotherapy. A retrospective single institutional study","volume":"73","author":"Saju","year":"2025","journal-title":"Neurol India"},{"key":"10.1016\/j.wneu.2026.124958_bib17","doi-asserted-by":"crossref","first-page":"e341","DOI":"10.1016\/j.wneu.2020.10.083","article-title":"Endoscopic endonasal pituitary surgery for nonfunctioning pituitary adenomas: long-term outcomes and management of recurrent tumors","volume":"146","author":"Bernat","year":"2021","journal-title":"World Neurosurg"},{"key":"10.1016\/j.wneu.2026.124958_bib18","doi-asserted-by":"crossref","first-page":"67","DOI":"10.3171\/2014.3.JNS131532","article-title":"Morbidity of repeat transsphenoidal surgery assessed in more than 1000 operations","volume":"121","author":"Jahangiri","year":"2014","journal-title":"J Neurosurg"},{"key":"10.1016\/j.wneu.2026.124958_bib19","doi-asserted-by":"crossref","first-page":"1386","DOI":"10.1001\/jama.2023.5444","article-title":"Diagnosis and management of pituitary adenomas: a review","volume":"329","author":"Tritos","year":"2023","journal-title":"JAMA"},{"key":"10.1016\/j.wneu.2026.124958_bib20","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1210\/jc.2010-1692","article-title":"Diagnosis and treatment of hyperprolactinemia: an Endocrine Society clinical practice guideline","volume":"96","author":"Melmed","year":"2011","journal-title":"J Clin Endocrinol Metab"},{"key":"10.1016\/j.wneu.2026.124958_bib21","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1111\/cen.14127","article-title":"Current perspectives on recurrent pituitary adenoma: the role and timing of surgery vs adjuvant treatment","volume":"92","author":"Hayhurst","year":"2020","journal-title":"Clin Endocrinol"},{"key":"10.1016\/j.wneu.2026.124958_bib22","doi-asserted-by":"crossref","first-page":"977","DOI":"10.3390\/diagnostics12040977","article-title":"Prognostic factors for recurrence in pituitary adenomas: recent progress and future directions","volume":"12","author":"Lu","year":"2022","journal-title":"Diagnostics"},{"key":"10.1016\/j.wneu.2026.124958_bib23","doi-asserted-by":"crossref","DOI":"10.1016\/j.clineuro.2020.106455","article-title":"The clinical features, recurrence risks and surgical strategies of bone invasive pituitary adenomas","volume":"201","author":"Zhu","year":"2021","journal-title":"Clin Neurol Neurosurg"},{"key":"10.1016\/j.wneu.2026.124958_bib24","doi-asserted-by":"crossref","first-page":"E10","DOI":"10.3171\/2011.1.FOCUS10317","article-title":"Endoscopic endonasal transsphenoidal surgery for functional pituitary adenomas","volume":"30","author":"Hofstetter","year":"2011","journal-title":"Neurosurg focus"},{"key":"10.1016\/j.wneu.2026.124958_bib25","doi-asserted-by":"crossref","first-page":"713","DOI":"10.1016\/j.wneu.2017.04.096","article-title":"Endoscopic endonasal surgery for tumors of the cavernous sinus: a series of 234 patients","volume":"103","author":"Koutourousiou","year":"2017","journal-title":"World Neurosurg"},{"key":"10.1016\/j.wneu.2026.124958_bib26","doi-asserted-by":"crossref","first-page":"2413","DOI":"10.3390\/diagnostics12102413","article-title":"Prognostic factors for invasiveness and recurrence of pituitary adenomas: a series of 94 patients","volume":"12","author":"Stefanidis","year":"2022","journal-title":"Diagnostics"},{"key":"10.1016\/j.wneu.2026.124958_bib27","doi-asserted-by":"crossref","first-page":"e118","DOI":"10.1016\/j.wneu.2018.07.056","article-title":"Recurrences of Pituitary Adenomas or Second De Novo Tumors: comparisons with First Tumors","volume":"119","author":"Saeger","year":"2018","journal-title":"World Neurosurg"},{"key":"10.1016\/j.wneu.2026.124958_bib28","doi-asserted-by":"crossref","first-page":"5007","DOI":"10.1038\/s41467-025-60028-5","article-title":"Single-cell and spatial transcriptome analyses reveal tumor heterogeneity and immune remodeling involved in pituitary neuroendocrine tumor progression","volume":"16","author":"Su","year":"2025","journal-title":"Nat Commun"},{"key":"10.1016\/j.wneu.2026.124958_bib29","doi-asserted-by":"crossref","DOI":"10.3389\/fendo.2022.837025","article-title":"Outcome of endoscopic transsphenoidal surgery for recurrent or residual pituitary adenomas and comparison to non-recurrent or residual cohort by propensity score analysis","volume":"13","author":"Gong","year":"2022","journal-title":"Front Endocrinol"},{"key":"10.1016\/j.wneu.2026.124958_bib30","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1016\/j.wneu.2017.02.131","article-title":"Extent of resection, visual, and endocrinologic outcomes for Endoscopic endonasal surgery for recurrent pituitary adenomas","volume":"102","author":"Do","year":"2017","journal-title":"World Neurosurg"},{"key":"10.1016\/j.wneu.2026.124958_bib31","doi-asserted-by":"crossref","first-page":"397","DOI":"10.3171\/2016.8.JNS152709","article-title":"Reoperative endoscopic endonasal surgery for residual or recurrent pituitary adenomas","volume":"127","author":"Negm","year":"2017","journal-title":"J Neurosurg"},{"key":"10.1016\/j.wneu.2026.124958_bib32","doi-asserted-by":"crossref","first-page":"2712","DOI":"10.3390\/jcm13092712","article-title":"The transorbital approach: a comprehensive review of targets, surgical techniques, and multiportal variants","volume":"13","author":"De Simone","year":"2024","journal-title":"J Clin Med"},{"key":"10.1016\/j.wneu.2026.124958_bib33","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1038\/s41574-024-00953-5","article-title":"The shift of therapeutic strategy for prolactinomas: surgery as the first-line option","volume":"20","author":"Wu","year":"2024","journal-title":"Nat Rev Endocrinol"},{"key":"10.1016\/j.wneu.2026.124958_bib34","first-page":"538","article-title":"Stereotactic radiosurgery outcomes in medically and surgically failed or nonsurgical candidates with medically failed prolactinomas: a systematic review and meta-analysis","volume":"846","author":"Yagnik","year":"2023","journal-title":"J Neurol Surg Part B, Skull base"},{"key":"10.1016\/j.wneu.2026.124958_bib35","doi-asserted-by":"crossref","DOI":"10.3389\/fendo.2021.624686","article-title":"Multimodal non-surgical treatments of aggressive pituitary tumors","volume":"12","author":"Nakano-Tateno","year":"2021","journal-title":"Front Endocrinol"},{"key":"10.1016\/j.wneu.2026.124958_bib36","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1016\/j.wneu.2022.12.131","article-title":"Proposal of a novel anatomic guide to the Sphenoid sinus","volume":"171","author":"Ojo","year":"2023","journal-title":"World Neurosurg"},{"key":"10.1016\/j.wneu.2026.124958_bib37","doi-asserted-by":"crossref","first-page":"1295","DOI":"10.1016\/j.crad.2014.07.010","article-title":"Benign and malignant diseases of the clivus","volume":"69","author":"Neelakantan","year":"2014","journal-title":"Clin Radiol"},{"key":"10.1016\/j.wneu.2026.124958_bib38","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1186\/s12893-025-03001-9","article-title":"Endoscopic endonasal approaches for resection of suprasellar pituitary neuroendocrine tumors: a novel classification based on the optic chiasm and operative nuances","volume":"25","author":"Wu","year":"2025","journal-title":"BMC Surg"},{"key":"10.1016\/j.wneu.2026.124958_bib39","first-page":"610","article-title":"Pituitary adenomas with invasion of the cavernous sinus space: a magnetic resonance imaging classification compared with surgical findings","volume":"33","author":"Knosp","year":"1993","journal-title":"Neurosurgery"},{"key":"10.1016\/j.wneu.2026.124958_bib40","article-title":"AKU giant pituitary adenoma score: a novel scoring system to predict the outcomes of surgery for giant pituitary adenomas","volume":"14","author":"Enam","year":"2022","journal-title":"Cureus"},{"key":"10.1016\/j.wneu.2026.124958_bib41","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1016\/j.wneu.2016.09.046","article-title":"The medial extra-sellar corridor to the cavernous sinus: anatomic description and clinical correlation","volume":"96","author":"Theodosopoulos","year":"2016","journal-title":"World Neurosurg"},{"key":"10.1016\/j.wneu.2026.124958_bib42","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1093\/neurosurgery\/16.CN_suppl_1.185","article-title":"Transphenoidal microsurgery of the normal and pathological pituitary","volume":"16","author":"Hardy","year":"1969","journal-title":"Clin Neurosurg"},{"key":"10.1016\/j.wneu.2026.124958_bib43","doi-asserted-by":"crossref","first-page":"1283","DOI":"10.1097\/00005537-200308000-00003","article-title":"Incidence, etiology, and management of cerebrospinal fluid leaks following trans-sphenoidal surgery","volume":"113","author":"Shiley","year":"2003","journal-title":"Laryngoscope"},{"key":"10.1016\/j.wneu.2026.124958_bib44","doi-asserted-by":"crossref","first-page":"621","DOI":"10.1080\/00016489.2021.1900600","article-title":"Risk factor for cerebrospinal fluid leak after endoscopic endonasal skull base surgery: a single-center experience","volume":"141","author":"Ozawa","year":"2021","journal-title":"Acta Otolaryngol"},{"key":"10.1016\/j.wneu.2026.124958_bib45","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1055\/s-0032-1333129","article-title":"Complex reconstruction of the sella using absorbable mini-plate in revision endoscopic pituitary surgery: technical note","volume":"74","author":"Tabaee","year":"2013","journal-title":"J Neurol Surg A, Cent Eur Neurosurg"}],"container-title":["World Neurosurgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1878875026001749?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1878875026001749?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T20:28:28Z","timestamp":1791232108000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1878875026001749"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6]]},"references-count":45,"alternative-id":["S1878875026001749"],"URL":"https:\/\/doi.org\/10.1016\/j.wneu.2026.124958","relation":{},"ISSN":["1878-8750"],"issn-type":[{"value":"1878-8750","type":"print"}],"subject":[],"published":{"date-parts":[[2026,6]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"A Proposed Classification and Scoring System Predicting Gross Total Resection of Recurrent and Residual Pituitary Adenoma: A Retrospective Study","name":"articletitle","label":"Article Title"},{"value":"World Neurosurgery","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.wneu.2026.124958","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 The Author(s). Published by Elsevier Inc.","name":"copyright","label":"Copyright"}],"article-number":"124958"}}