{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T10:49:43Z","timestamp":1792147783728,"version":"4.4.0"},"reference-count":22,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2019,5,12]],"date-time":"2019-05-12T00:00:00Z","timestamp":1557619200000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Operative Surg.","ONSURG"],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>The influence of the surgeon's preoperative goal regarding the extent of tumor resection on patient outcomes has not been carefully studied among patients with nonfunctioning pituitary adenomas.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>To analyze the relationship between surgical tumor removal goal and patient outcomes in a prospective multicenter study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Centrally adjudicated extent of tumor resection (gross total resection [GTR] and subtotal resection [STR]) data were analyzed using standard univariate and multivariable analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      GTR was accomplished in 148 of 171 (86.5%) patients with planned GTR and 32 of 50 (64.0%) patients with planned STR (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u00a0=\u00a0.001). Sensitivity, specificity, positive predictive value, and negative predictive value of GTR goal were 82.2, 43.9, 86.5, and 36.0%, respectively. Knosp grade 0-2, first surgery, and being an experienced surgeon were associated with surgeons choosing GTR as the goal (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u00a0&lt;\u00a0.01). There was no association between surgical goal and presence of pituitary deficiency at 6 mo (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u00a0=\u00a0.31). Tumor Knosp grade (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u00a0=\u00a0.004) and size (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u00a0=\u00a0.001) were stronger predictors of GTR than was surgical goal (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u00a0=\u00a0.014). The most common site of residual tumor was the cavernous sinus (29 of 41 patients; 70.1%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>This is the first pituitary surgery study to examine surgical goal regarding extent of tumor resection and associated patient outcomes. Surgical goal is a poor predictor of actual tumor resection. A more aggressive surgical goal does not correlate with pituitary gland dysfunction. A better understanding of the ability of surgeons to meet their expectations and of the factors associated with surgical result should improve prognostication and preoperative counseling.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ons\/opz085","type":"journal-article","created":{"date-parts":[[2019,5,11]],"date-time":"2019-05-11T21:09:38Z","timestamp":1557608978000},"page":"26-33","source":"Crossref","is-referenced-by-count":19,"title":["Evaluation of Surgical Resection Goal and Its Relationship to Extent of Resection and Patient Outcomes in a Multicenter Prospective Study of Patients With Surgically Treated, Nonfunctioning Pituitary Adenomas: A Case Series"],"prefix":"10.1227","volume":"18","author":[{"given":"Andrew S","family":"Little","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael R","family":"Chicoine","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Washington University School of Medicine, St. Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel F","family":"Kelly","sequence":"additional","affiliation":[{"name":"Pacific Brain Tumor Center and Pituitary Disorders Program, John Wayne Cancer Institute at Providence Saint John's Health Center, Santa Monica, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina E","family":"Sarris","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael A","family":"Mooney","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William L","family":"White","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul A","family":"Gardner","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Pittsburgh, Pittsburgh, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan C","family":"Fernandez-Miranda","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Pittsburgh, Pittsburgh, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Garni","family":"Barkhoudarian","sequence":"additional","affiliation":[{"name":"Pacific Brain Tumor Center and Pituitary Disorders Program, John Wayne Cancer Institute at Providence Saint John's Health Center, Santa Monica, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James P","family":"Chandler","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel M","family":"Prevedello","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, The Ohio State University, Columbus, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brandon D","family":"Liebelt","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Sfondouris","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc R","family":"Mayberg","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Washington, Seattle, Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"TRANSSPHER Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2020,1]]},"reference":[{"issue":"1","key":"bib1-20231022","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1136\/neurintsurg-2014-011515","article-title":"Comparing routine versus selective use of intraoperative cerebral angiography in aneurysm surgery: a prospective study","volume":"8","author":"Washington","year":"2016","journal-title":"J Neurointervent Surg"},{"issue":"2","key":"bib2-20231022","doi-asserted-by":"crossref","first-page":"230","DOI":"10.3171\/jns.2004.100.2.0230","article-title":"Comparison of 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