{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T15:26:54Z","timestamp":1772724414900,"version":"3.50.1"},"reference-count":52,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,7,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Stereotactic radiosurgery (SRS) offers excellent tumor control for pituitary adenoma (PA); however, treatment failure occasionally necessitates salvage surgery. Comprehensive studies on salvage surgical outcomes for recurrent PA after SRS remain scarce. This study aimed to elucidate the outcomes of salvage endonasal transsphenoidal surgery (sETS) for progressive PA failing SRS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>This retrospective, two institution\u2013based cohort study analyzed data from patients who underwent sETS for progressive PA failing SRS. Progression-free survival (PFS), disease-specific survival (DSS), and neurological and endocrinological outcomes in the sETS group were analyzed and compared with those in the primary ETS (pETS) group after propensity score matching using the following variables: age at surgery, maximum tumor diameter, highest Knosp\u2013Steiner classification, and tumor type.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Thirteen sETS patients (8 males [62%], median age at surgery of 56 years) with 5 nonfunctioning (39%), 6 corticotropic (46%), and 2 other functioning (15%) PAs who received median (range) follow-up of 125 ( 23\u2013169) months were included. None of the patients experienced new neurological deficits or death after sETS. The median (range) tumor resection rate was 90% (80%\u2013100%). The 5-year PFS and DSS rates were 55% and 77%, respectively. All 4 patients (31%) who experienced recurrence after sETS had corticotropic tumors. In the matched cohort analysis between the sETS group with 12 patients and the pETS group with 12 patients, no significant differences were observed in surgical outcomes. PFS rates were marginally higher in the sETS group than in the pETS group (80% vs 49% at 3 years, p = 0.216, log-rank test), and DSS was similar between the two groups (p = 0.543, log-rank test).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>The authors\u2019 results indicate that ETS can be safely performed as a salvage treatment after failed SRS with low complication rates and satisfactory tumor control in treatment-resistant PA.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2024.10.jns241682","type":"journal-article","created":{"date-parts":[[2025,2,28]],"date-time":"2025-02-28T20:45:24Z","timestamp":1740775524000},"page":"165-173","source":"Crossref","is-referenced-by-count":0,"title":["Safe and efficacious therapeutic outcomes with salvage endonasal transsphenoidal surgery for pituitary adenoma progression following stereotactic radiosurgery"],"prefix":"10.3171","volume":"143","author":[{"given":"Yuki","family":"Shinya","sequence":"first","affiliation":[{"name":"Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota;"},{"name":"Department of Neurosurgery, The University of Tokyo Hospital, Tokyo, Japan;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sukwoo","family":"Hong","sequence":"additional","affiliation":[{"name":"Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota;"},{"name":"Department of Neurosurgery, The University of Tokyo Hospital, Tokyo, Japan;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christoph","family":"Wipplinger","sequence":"additional","affiliation":[{"name":"Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hirotaka","family":"Hasegawa","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The University of Tokyo Hospital, Tokyo, Japan;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dana","family":"Erickson","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Diabetes, and Nutrition, Mayo Clinic, Rochester, Minnesota; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Irina","family":"Bancos","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Diabetes, and Nutrition, Mayo Clinic, Rochester, Minnesota; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Justine S.","family":"Herndon","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Diabetes, and Nutrition, Mayo Clinic, Rochester, Minnesota; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tamara M.","family":"Wipplinger","sequence":"additional","affiliation":[{"name":"Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandhya R.","family":"Palit","sequence":"additional","affiliation":[{"name":"Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masahiro","family":"Shin","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The University of Tokyo Hospital, Tokyo, Japan;"},{"name":"Department of Neurosurgery, Teikyo University Hospital, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael J.","family":"Link","sequence":"additional","affiliation":[{"name":"Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bruce E.","family":"Pollock","sequence":"additional","affiliation":[{"name":"Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John L. D.","family":"Atkinson","sequence":"additional","affiliation":[{"name":"Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nobuhito","family":"Saito","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The University of Tokyo Hospital, Tokyo, Japan;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jamie J.","family":"Van Gompel","sequence":"additional","affiliation":[{"name":"Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota;"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"6","key":"b1","series-title":"Neurosurg Focus","first-page":"E18","article-title":"Incidental pituitary adenomas","volume":"31","author":"Sivakumar W","year":"2011","unstructured":"Sivakumar W, Chamoun R, Nguyen V, Couldwell WT. Incidental pituitary adenomas. Neurosurg Focus. 2011;31(6):E18."},{"issue":"3","key":"b2","series-title":"Cancer","first-page":"613","article-title":"The prevalence of pituitary adenomas: a systematic review","volume":"101","author":"Ezzat S","year":"2004","unstructured":"Ezzat S, Asa SL, Couldwell WT,  The prevalence of pituitary adenomas: a systematic review. Cancer. 2004;101(3):613\u2013619."},{"issue":"16","key":"b3","series-title":"JAMA","first-page":"1386","article-title":"Diagnosis and management of pituitary adenomas: a review","volume":"329","author":"Tritos NA","year":"2023","unstructured":"Tritos NA, Miller KK. Diagnosis and management of pituitary adenomas: a review. JAMA. 2023;329(16):1386\u20131398."},{"issue":"1 Suppl","key":"b4","series-title":"Neurosurgery","first-page":"168","article-title":"Transcranial surgery for pituitary adenomas","volume":"57","author":"Youssef AS","year":"2005","unstructured":"Youssef AS, Agazzi S, van Loveren HR. Transcranial surgery for pituitary adenomas. Neurosurgery. 2005;57(1 Suppl):168\u2013175."},{"issue":"10","key":"b5","series-title":"Mayo Clin Proc","first-page":"1861","article-title":"Pituitary adenoma incidence, management trends, and long-term outcomes: a 30-year population-based analysis","volume":"97","author":"Graffeo CS","year":"2022","unstructured":"Graffeo CS, Yagnik KJ, Carlstrom LP,  Pituitary adenoma incidence, management trends, and long-term outcomes: a 30-year population-based analysis. Mayo Clin Proc. 2022;97(10):1861\u20131871."},{"issue":"3","key":"b6","series-title":"Neuro Oncol","first-page":"318","article-title":"Stereotactic radiosurgery for non-functioning pituitary adenomas: meta-analysis and International Stereotactic Radiosurgery Society practice opinion","volume":"22","author":"Kotecha R","year":"2020","unstructured":"Kotecha R, Sahgal A, Rubens M,  Stereotactic radiosurgery for non-functioning pituitary adenomas: meta-analysis and International Stereotactic Radiosurgery Society practice opinion. Neuro Oncol. 2020;22(3):318\u2013332."},{"issue":"3","key":"b7","series-title":"J Neurosurg","first-page":"801","article-title":"Stereotactic radiosurgery for secretory pituitary adenomas: systematic review and International Stereotactic Radiosurgery Society practice recommendations","volume":"136","author":"Mathieu D","year":"2021","unstructured":"Mathieu D, Kotecha R, Sahgal A,  Stereotactic radiosurgery for secretory pituitary adenomas: systematic review and International Stereotactic Radiosurgery Society practice recommendations. J Neurosurg. 2021;136(3):801\u2013812."},{"issue":"6","key":"b8","series-title":"Pituitary","first-page":"539","article-title":"Feasibility and outcome of re-irradiation in the treatment of multiply recurrent pituitary adenomas","volume":"17","author":"Verma J","year":"2014","unstructured":"Verma J, McCutcheon IE, Waguespack SG, Mahajan A. Feasibility and outcome of re-irradiation in the treatment of multiply recurrent pituitary adenomas. Pituitary. 2014;17(6):539\u2013545."},{"issue":"4","key":"b9","series-title":"Neurosurgery","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 E","year":"1993","unstructured":"Knosp E, Steiner E, Kitz K, Matula C. Pituitary adenomas with invasion of the cavernous sinus space: a magnetic resonance imaging classification compared with surgical findings. Neurosurgery. 1993;33(4):610\u2013618."},{"issue":"4","key":"b10","series-title":"J Neurosurg","first-page":"1043","article-title":"Results of a prospective multicenter controlled study comparing surgical outcomes of microscopic versus fully endoscopic transsphenoidal surgery for nonfunctioning pituitary adenomas: the Transsphenoidal Extent of Resection (TRANSSPHER) Study","volume":"132","author":"Little AS","year":"2019","unstructured":"Little AS, Kelly DF, White WL,  Results of a prospective multicenter controlled study comparing surgical outcomes of microscopic versus fully endoscopic transsphenoidal surgery for nonfunctioning pituitary adenomas: the Transsphenoidal Extent of Resection (TRANSSPHER) Study. J Neurosurg. 2019;132(4):1043\u20131053."},{"issue":"8","key":"b11","series-title":"Mayo Clin Proc","first-page":"2043","article-title":"Pituitary tumor surgery: comparison of endoscopic and microscopic techniques at a single center","volume":"96","author":"Van Gompel JJ","year":"2021","unstructured":"Van Gompel JJ, Atkinson JLD, Choby G,  Pituitary tumor surgery: comparison of endoscopic and microscopic techniques at a single center. Mayo Clin Proc. 2021;96(8):2043\u20132057."},{"issue":"3","key":"b12","series-title":"Endocrine","first-page":"595","article-title":"Frequency, pattern, and outcome of recurrences after Gamma Knife radiosurgery for pituitary adenomas","volume":"56","author":"Losa M","year":"2017","unstructured":"Losa M, Spatola G, Albano L,  Frequency, pattern, and outcome of recurrences after Gamma Knife radiosurgery for pituitary adenomas. Endocrine. 2017;56(3):595\u2013602."},{"issue":"3","key":"b13","series-title":"J Neurosurg","first-page":"781","article-title":"Correlation of older age with better progression-free survival despite less aggressive resection in nonfunctioning pituitary adenomas","volume":"141","author":"Shinya Y","year":"2024","unstructured":"Shinya Y, Atkinson JLD, Erickson D,  Correlation of older age with better progression-free survival despite less aggressive resection in nonfunctioning pituitary adenomas. J Neurosurg. 2024;141(3):781\u2013789."},{"issue":"5","key":"b14","series-title":"JAMA","first-page":"516","article-title":"Diagnosis and treatment of pituitary adenomas: a review","volume":"317","author":"Molitch ME","year":"2017","unstructured":"Molitch ME. Diagnosis and treatment of pituitary adenomas: a review. JAMA. 2017;317(5):516\u2013524."},{"issue":"7","key":"b15","series-title":"J Clin Endocrinol Metab","first-page":"1585","article-title":"Aggressive pituitary tumors and pituitary carcinomas: from pathology to treatment","volume":"108","author":"Burman P","year":"2023","unstructured":"Burman P, Casar-Borota O, Perez-Rivas LG, Dekkers OM. Aggressive pituitary tumors and pituitary carcinomas: from pathology to treatment. J Clin Endocrinol Metab. 2023;108(7):1585\u20131601."},{"issue":"6","key":"b16","series-title":"J Neurosurg","first-page":"1004","article-title":"Repeated transsphenoidal surgery to treat recurrent or residual pituitary adenoma","volume":"102","author":"Benveniste RJ","year":"2005","unstructured":"Benveniste RJ, King WA, Walsh J, Lee JS, Delman BN, Post KD. Repeated transsphenoidal surgery to treat recurrent or residual pituitary adenoma. J Neurosurg. 2005;102(6):1004\u20131012."},{"issue":"Suppl","key":"b17","series-title":"J Neurosurg","first-page":"51","article-title":"Comparison of radiation dose spillage from the Gamma Knife Perfexion with that from volumetric modulated arc radiosurgery during treatment of multiple brain metastases in a single fraction","volume":"121","author":"McDonald D","year":"2014","unstructured":"McDonald D, Schuler J, Takacs I, Peng J, Jenrette J, Vanek K. Comparison of radiation dose spillage from the Gamma Knife Perfexion with that from volumetric modulated arc radiosurgery during treatment of multiple brain metastases in a single fraction. J Neurosurg. 2014;121(Suppl):51-59."},{"issue":"3","key":"b18","series-title":"Neurosurg Focus","first-page":"E4","article-title":"Radiobiology of brain metastasis: applications in stereotactic radiosurgery","volume":"22","author":"Jagannathan J","year":"2007","unstructured":"Jagannathan J, Sherman JH, Mehta GU, Chin LS. Radiobiology of brain metastasis: applications in stereotactic radiosurgery. Neurosurg Focus. 2007;22(3):E4."},{"issue":"1","key":"b19","series-title":"J Neurosurg","first-page":"67","article-title":"Morbidity of repeat transsphenoidal surgery assessed in more than 1000 operations","volume":"121","author":"Jahangiri A","year":"2014","unstructured":"Jahangiri A, Wagner J, Han SW,  Morbidity of repeat transsphenoidal surgery assessed in more than 1000 operations. J Neurosurg. 2014;121(1):67\u201374."},{"issue":"2","key":"b20","series-title":"J Neurosurg","first-page":"446","article-title":"Gamma Knife radiosurgery for the management of nonfunctioning pituitary adenomas: a multicenter study","volume":"119","author":"Sheehan JP","year":"2013","unstructured":"Sheehan JP, Starke RM, Mathieu D,  Gamma Knife radiosurgery for the management of nonfunctioning pituitary adenomas: a multicenter study. J Neurosurg. 2013;119(2):446\u2013456."},{"key":"b21","series-title":"Front Oncol","first-page":"627428","article-title":"Characteristic of tumor regrowth after gamma knife radiosurgery and outcomes of repeat gamma knife radiosurgery in nonfunctioning pituitary adenomas","volume":"11","author":"Li Y","year":"2021","unstructured":"Li Y, Wu L, Quan T,  Characteristic of tumor regrowth after gamma knife radiosurgery and outcomes of repeat gamma knife radiosurgery in nonfunctioning pituitary adenomas. Front Oncol. 2021;11:627428."},{"issue":"2","key":"b22","series-title":"Acta Neuropathol","first-page":"97","article-title":"The 2007 WHO Classification of Tumours of the Central Nervous System","volume":"114","author":"Louis DN","year":"2007","unstructured":"Louis DN, Ohgaki H, Wiestler OD,  The 2007 WHO Classification of Tumours of the Central Nervous System. Acta Neuropathol. 2007;114(2):97\u2013109."},{"issue":"3","key":"b23","series-title":"J Neurooncol","first-page":"459","article-title":"Management of aggressive pituitary adenomas and pituitary carcinomas","volume":"117","author":"Heaney A","year":"2014","unstructured":"Heaney A. Management of aggressive pituitary adenomas and pituitary carcinomas. J Neurooncol. 2014;117(3):459\u2013468."},{"issue":"6","key":"b24","series-title":"Acta Neuropathol","first-page":"803","article-title":"The 2016 World Health Organization Classification of Tumors of the Central Nervous System: a summary","volume":"131","author":"Louis DN","year":"2016","unstructured":"Louis DN, Perry A, Reifenberger G,  The 2016 World Health Organization Classification of Tumors of the Central Nervous System: a summary. Acta Neuropathol. 2016;131(6):803\u2013820."},{"issue":"8","key":"b25","series-title":"Neuro Oncol","first-page":"1231","article-title":"The 2021 WHO Classification of Tumors of the Central Nervous System: a summary","volume":"23","author":"Louis DN","year":"2021","unstructured":"Louis DN, Perry A, Wesseling P,  The 2021 WHO Classification of Tumors of the Central Nervous System: a summary. Neuro Oncol. 2021;23(8):1231\u20131251."},{"issue":"3","key":"b26","series-title":"Eur J Endocrinol","first-page":"265","article-title":"Treatment of aggressive pituitary tumours and carcinomas: results of a European Society of Endocrinology (ESE) survey 2016","volume":"178","author":"McCormack A","year":"2018","unstructured":"McCormack A, Dekkers OM, Petersenn S,  Treatment of aggressive pituitary tumours and carcinomas: results of a European Society of Endocrinology (ESE) survey 2016. Eur J Endocrinol. 2018;178(3):265\u2013276."},{"issue":"6","key":"b1","series-title":"Neurosurg Focus","first-page":"E18","article-title":"Incidental pituitary adenomas","volume":"31","author":"Sivakumar W","year":"2011","unstructured":"Sivakumar W, Chamoun R, Nguyen V, Couldwell WT. Incidental pituitary adenomas. Neurosurg Focus. 2011;31(6):E18."},{"issue":"3","key":"b2","series-title":"Cancer","first-page":"613","article-title":"The prevalence of pituitary adenomas: a systematic review","volume":"101","author":"Ezzat S","year":"2004","unstructured":"Ezzat S, Asa SL, Couldwell WT,  The prevalence of pituitary adenomas: a systematic review. Cancer. 2004;101(3):613\u2013619."},{"issue":"16","key":"b3","series-title":"JAMA","first-page":"1386","article-title":"Diagnosis and management of pituitary adenomas: a review","volume":"329","author":"Tritos NA","year":"2023","unstructured":"Tritos NA, Miller KK. Diagnosis and management of pituitary adenomas: a review. 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Mayo Clin Proc. 2022;97(10):1861\u20131871."},{"issue":"3","key":"b6","series-title":"Neuro Oncol","first-page":"318","article-title":"Stereotactic radiosurgery for non-functioning pituitary adenomas: meta-analysis and International Stereotactic Radiosurgery Society practice opinion","volume":"22","author":"Kotecha R","year":"2020","unstructured":"Kotecha R, Sahgal A, Rubens M,  Stereotactic radiosurgery for non-functioning pituitary adenomas: meta-analysis and International Stereotactic Radiosurgery Society practice opinion. Neuro Oncol. 2020;22(3):318\u2013332."},{"issue":"3","key":"b7","series-title":"J Neurosurg","first-page":"801","article-title":"Stereotactic radiosurgery for secretory pituitary adenomas: systematic review and International Stereotactic Radiosurgery Society practice recommendations","volume":"136","author":"Mathieu D","year":"2021","unstructured":"Mathieu D, Kotecha R, Sahgal A,  Stereotactic radiosurgery for secretory pituitary adenomas: systematic review and International Stereotactic Radiosurgery Society practice recommendations. J Neurosurg. 2021;136(3):801\u2013812."},{"issue":"6","key":"b8","series-title":"Pituitary","first-page":"539","article-title":"Feasibility and outcome of re-irradiation in the treatment of multiply recurrent pituitary adenomas","volume":"17","author":"Verma J","year":"2014","unstructured":"Verma J, McCutcheon IE, Waguespack SG, Mahajan A. Feasibility and outcome of re-irradiation in the treatment of multiply recurrent pituitary adenomas. Pituitary. 2014;17(6):539\u2013545."},{"issue":"4","key":"b9","series-title":"Neurosurgery","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 E","year":"1993","unstructured":"Knosp E, Steiner E, Kitz K, Matula C. Pituitary adenomas with invasion of the cavernous sinus space: a magnetic resonance imaging classification compared with surgical findings. Neurosurgery. 1993;33(4):610\u2013618."},{"issue":"4","key":"b10","series-title":"J Neurosurg","first-page":"1043","article-title":"Results of a prospective multicenter controlled study comparing surgical outcomes of microscopic versus fully endoscopic transsphenoidal surgery for nonfunctioning pituitary adenomas: the Transsphenoidal Extent of Resection (TRANSSPHER) Study","volume":"132","author":"Little AS","year":"2019","unstructured":"Little AS, Kelly DF, White WL,  Results of a prospective multicenter controlled study comparing surgical outcomes of microscopic versus fully endoscopic transsphenoidal surgery for nonfunctioning pituitary adenomas: the Transsphenoidal Extent of Resection (TRANSSPHER) Study. J Neurosurg. 2019;132(4):1043\u20131053."},{"issue":"8","key":"b11","series-title":"Mayo Clin Proc","first-page":"2043","article-title":"Pituitary tumor surgery: comparison of endoscopic and microscopic techniques at a single center","volume":"96","author":"Van Gompel JJ","year":"2021","unstructured":"Van Gompel JJ, Atkinson JLD, Choby G,  Pituitary tumor surgery: comparison of endoscopic and microscopic techniques at a single center. Mayo Clin Proc. 2021;96(8):2043\u20132057."},{"issue":"3","key":"b12","series-title":"Endocrine","first-page":"595","article-title":"Frequency, pattern, and outcome of recurrences after Gamma Knife radiosurgery for pituitary adenomas","volume":"56","author":"Losa M","year":"2017","unstructured":"Losa M, Spatola G, Albano L,  Frequency, pattern, and outcome of recurrences after Gamma Knife radiosurgery for pituitary adenomas. Endocrine. 2017;56(3):595\u2013602."},{"issue":"3","key":"b13","series-title":"J Neurosurg","first-page":"781","article-title":"Correlation of older age with better progression-free survival despite less aggressive resection in nonfunctioning pituitary adenomas","volume":"141","author":"Shinya Y","year":"2024","unstructured":"Shinya Y, Atkinson JLD, Erickson D,  Correlation of older age with better progression-free survival despite less aggressive resection in nonfunctioning pituitary adenomas. J Neurosurg. 2024;141(3):781\u2013789."},{"issue":"5","key":"b14","series-title":"JAMA","first-page":"516","article-title":"Diagnosis and treatment of pituitary adenomas: a review","volume":"317","author":"Molitch ME","year":"2017","unstructured":"Molitch ME. Diagnosis and treatment of pituitary adenomas: a review. JAMA. 2017;317(5):516\u2013524."},{"issue":"7","key":"b15","series-title":"J Clin Endocrinol Metab","first-page":"1585","article-title":"Aggressive pituitary tumors and pituitary carcinomas: from pathology to treatment","volume":"108","author":"Burman P","year":"2023","unstructured":"Burman P, Casar-Borota O, Perez-Rivas LG, Dekkers OM. Aggressive pituitary tumors and pituitary carcinomas: from pathology to treatment. J Clin Endocrinol Metab. 2023;108(7):1585\u20131601."},{"issue":"6","key":"b16","series-title":"J Neurosurg","first-page":"1004","article-title":"Repeated transsphenoidal surgery to treat recurrent or residual pituitary adenoma","volume":"102","author":"Benveniste RJ","year":"2005","unstructured":"Benveniste RJ, King WA, Walsh J, Lee JS, Delman BN, Post KD. Repeated transsphenoidal surgery to treat recurrent or residual pituitary adenoma. J Neurosurg. 2005;102(6):1004\u20131012."},{"issue":"Suppl","key":"b17","series-title":"J Neurosurg","first-page":"51","article-title":"Comparison of radiation dose spillage from the Gamma Knife Perfexion with that from volumetric modulated arc radiosurgery during treatment of multiple brain metastases in a single fraction","volume":"121","author":"McDonald D","year":"2014","unstructured":"McDonald D, Schuler J, Takacs I, Peng J, Jenrette J, Vanek K. Comparison of radiation dose spillage from the Gamma Knife Perfexion with that from volumetric modulated arc radiosurgery during treatment of multiple brain metastases in a single fraction. J Neurosurg. 2014;121(Suppl):51-59."},{"issue":"3","key":"b18","series-title":"Neurosurg Focus","first-page":"E4","article-title":"Radiobiology of brain metastasis: applications in stereotactic radiosurgery","volume":"22","author":"Jagannathan J","year":"2007","unstructured":"Jagannathan J, Sherman JH, Mehta GU, Chin LS. Radiobiology of brain metastasis: applications in stereotactic radiosurgery. Neurosurg Focus. 2007;22(3):E4."},{"issue":"1","key":"b19","series-title":"J Neurosurg","first-page":"67","article-title":"Morbidity of repeat transsphenoidal surgery assessed in more than 1000 operations","volume":"121","author":"Jahangiri A","year":"2014","unstructured":"Jahangiri A, Wagner J, Han SW,  Morbidity of repeat transsphenoidal surgery assessed in more than 1000 operations. J Neurosurg. 2014;121(1):67\u201374."},{"issue":"2","key":"b20","series-title":"J Neurosurg","first-page":"446","article-title":"Gamma Knife radiosurgery for the management of nonfunctioning pituitary adenomas: a multicenter study","volume":"119","author":"Sheehan JP","year":"2013","unstructured":"Sheehan JP, Starke RM, Mathieu D,  Gamma Knife radiosurgery for the management of nonfunctioning pituitary adenomas: a multicenter study. J Neurosurg. 2013;119(2):446\u2013456."},{"key":"b21","series-title":"Front Oncol","first-page":"627428","article-title":"Characteristic of tumor regrowth after gamma knife radiosurgery and outcomes of repeat gamma knife radiosurgery in nonfunctioning pituitary adenomas","volume":"11","author":"Li Y","year":"2021","unstructured":"Li Y, Wu L, Quan T,  Characteristic of tumor regrowth after gamma knife radiosurgery and outcomes of repeat gamma knife radiosurgery in nonfunctioning pituitary adenomas. Front Oncol. 2021;11:627428."},{"issue":"2","key":"b22","series-title":"Acta Neuropathol","first-page":"97","article-title":"The 2007 WHO Classification of Tumours of the Central Nervous System","volume":"114","author":"Louis DN","year":"2007","unstructured":"Louis DN, Ohgaki H, Wiestler OD,  The 2007 WHO Classification of Tumours of the Central Nervous System. 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