{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T08:08:40Z","timestamp":1790842120370,"version":"4.1.0"},"reference-count":14,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,5,5]],"date-time":"2020-05-05T00:00:00Z","timestamp":1588636800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Pituitary neuroendocrine tumours <jats:italic>(PitNET)s<\/jats:italic> can be aggressive, thus presenting local invasion, postsurgical recurrence and\/or resistance to treatment, responsible for significant morbidity. The study aimed at identifying prognostic factors of postsurgical outcome using data\u2010driven classification of patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Retrospective observational study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Clinicopathological and radiological data of patients with <jats:italic>PitNET<\/jats:italic> treated via endoscopic endonasal surgery were collected. Tumour recurrence\/progression and progression\u2010free survival were assessed by classification tree analysis (CTA) and Kaplan\u2010Meier curves, respectively. Histological subtype, cavernous\/sphenoid sinus invasion, mitosis, Ki\u201067, p53, Trouillas\u2019 grading, degree of tumour exeresis and postsurgery disease activity were also evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 1066 (466 <jats:italic>gonadotroph<\/jats:italic>, 287 <jats:italic>somatotroph<\/jats:italic>, 148 <jats:italic>lactotroph<\/jats:italic>, 157 <jats:italic>corticotroph<\/jats:italic> and 8 <jats:italic>thyrotroph<\/jats:italic>) tumours were included; 21.7% invaded the cavernous\/sphenoid sinus. Based on Trouillas\u2019 classification, 64.3% were grade 1a, 14.2% 1b, 16.1% 2a, and 5.4% 2b; 18.3% had &gt;2\/10 HPF mitoses, 24.9% had Ki\u201067 \u22653%; 15.8% were positive for p53. Exeresis was radical in 81.2% of the cases. Median follow\u2010up was 59.2\u00a0months. At last evaluation, 79.4% of the patients were cured; 20.6% had disease persistence, controlled by medical treatment in 18.3% of them. Disease recurrence\/progression was recorded in 10.9% of the cases. CTA identified 5 distinct patient subgroups with different risk of disease recurrence\/progression. Grade 2 of the Trouillas\u2019 grading, &gt;2\/10 HPF mitoses, Ki\u201067 \u22653%, p53 protein expression (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001), tumour invasion (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.002) and ACTH\u2010subtype (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.003) were identified as risk factors of disease recurrence\/progression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The combined evaluation of Trouillas\u2019 grading, proliferation indexes and immunohistochemistry appears promising in the prediction of surgical outcome in <jats:italic>PitNET<\/jats:italic>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.14197","type":"journal-article","created":{"date-parts":[[2020,4,19]],"date-time":"2020-04-19T19:04:36Z","timestamp":1587323076000},"page":"36-43","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":40,"title":["A practical algorithm to predict postsurgical recurrence and progression of pituitary neuroendocrine tumours (<i>PitNET<\/i>)s"],"prefix":"10.1111","volume":"93","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8416-1669","authenticated-orcid":false,"given":"Federica","family":"Guaraldi","sequence":"first","affiliation":[{"name":"IRCCS Istituto delle Scienze Neurologiche di Bologna Bologna Italy"},{"name":"Department of Biomedical and Neuromotor Sciences (DIBINEM) University of Bologna Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo","family":"Zoli","sequence":"additional","affiliation":[{"name":"IRCCS Istituto delle Scienze Neurologiche di Bologna Bologna Italy"},{"name":"Department of Biomedical and Neuromotor Sciences (DIBINEM) University of Bologna Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1074-0155","authenticated-orcid":false,"given":"Alberto","family":"Righi","sequence":"additional","affiliation":[{"name":"Department of Pathology IRCCS Istituto Ortopedico Rizzoli Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dino","family":"Gibertoni","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Neuromotor Sciences (DIBINEM) Unit of Hygiene and Biostatistics University of Bologna Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentino","family":"Marino Picciola","sequence":"additional","affiliation":[{"name":"IRCCS Istituto delle Scienze Neurologiche di Bologna Bologna Italy"},{"name":"Department of Biomedical and Neuromotor Sciences (DIBINEM) University of Bologna Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Faustini\u2010Fustini","sequence":"additional","affiliation":[{"name":"IRCCS Istituto delle Scienze Neurologiche di Bologna Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Morandi","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Neuromotor Sciences (DIBINEM) University of Bologna Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonella","family":"Bacci","sequence":"additional","affiliation":[{"name":"Division of Neuroradiology IRCCS Istituto delle Scienze Neurologiche di Bologna Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ernesto","family":"Pasquini","sequence":"additional","affiliation":[{"name":"ENT Division Bellaria Hospital Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diego","family":"Mazzatenta","sequence":"additional","affiliation":[{"name":"IRCCS Istituto delle Scienze Neurologiche di Bologna Bologna Italy"},{"name":"Department of Biomedical and Neuromotor Sciences (DIBINEM) University of Bologna Bologna Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5035-2448","authenticated-orcid":false,"given":"Sofia","family":"Asioli","sequence":"additional","affiliation":[{"name":"IRCCS Istituto delle Scienze Neurologiche di Bologna Bologna Italy"},{"name":"Department of Biomedical and Neuromotor Sciences (DIBINEM) Section of Anatomic Pathology 'M. 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