{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:21:09Z","timestamp":1787026869229,"version":"build-2736575974"},"reference-count":28,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T00:00:00Z","timestamp":1776297600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>This retrospective, single-center study aimed to identify predictive factors for progression in postoperative residual findings of non-functioning pituitary macroadenomas (NFPMAs). The findings are intended to support individualized decisions regarding follow-up and adjuvant therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective analysis was conducted on 212 patients treated at a tertiary referral center between 2007 and 2023. Patients underwent MRI-guided, transnasal transsphenoidal surgery for histologically confirmed NFPMAs. Pre- and postoperative tumor volumes were assessed alongside demographic, clinical, and histopathological data. Tumor configuration was classified using Hardy and Knosp scales. Subgroups were defined based on postoperative imaging: stable residuals, progressive residuals, or recurrence after gross total resection (GTR). Statistical analyses included multivariate testing and ROC analysis to determine predictive cutoff values.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of the 212 patients, initial radiological gross total resection (GTR) was achieved in 94\/212 (44.3%); during follow-up, 62\/212 (29.2%) had durable complete resection without recurrence, while 32\/212 (15.1%) developed recurrence after initial GTR. Among patients with residual findings, 76 (64.4%) exhibited stable tumors after a mean of follow-up of 39\u202fmonths, while 42 (35.6%) showed progression, which correlated significantly with larger preoperative tumor volumes (median: 11.6\u202fcm\n                      <jats:sup>3<\/jats:sup>\n                      vs. 5.81\u202fcm\n                      <jats:sup>3<\/jats:sup>\n                      ,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001). ROC analysis identified 7.12\u202fcm\n                      <jats:sup>3<\/jats:sup>\n                      as the optimal cutoff for distinguishing stable from progressive residual tumor volumes (AUC\u202f=\u202f0.748). No significant differences between stable and progressive groups were observed in Hardy or Knosp classifications. Postoperative cortisol levels were nominally higher in patients with progressive residuals (14.10\u202f\u03bcg\/dL vs. 10.83\u202f\u03bcg\/dL;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.022; exploratory).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      According to our study, preoperative and postoperative tumor volumes represent pragmatic prognostic markers of progression in NFPMAs, with a critical cutoff of 7.12\u202fcm\n                      <jats:sup>3<\/jats:sup>\n                      for stability. These findings could inform tailored follow-up strategies. Prospective studies are warranted to validate these results and further explore the impact of surgical and tumor characteristics on long-term outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2026.1763660","type":"journal-article","created":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T04:21:08Z","timestamp":1776313268000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Predicting tumor progression in non-functioning pituitary macroadenomas following transnasal transsphenoidal resection: insights from a single-center retrospective cohort study"],"prefix":"10.3389","volume":"17","author":[{"given":"Viktor M.","family":"Eisenkolb","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, TUM Klinikum, Technical University of Munich","place":["Munich, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Schneider","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, TUM Klinikum, Technical University of Munich","place":["Munich, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michel","family":"Mondragon-Soto","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, National Institute of Neurology and Neurosurgery","place":["Mexico City, Mexico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Quiring","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, TUM Klinikum, Technical University of Munich","place":["Munich, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernhard","family":"Meyer","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, TUM Klinikum, Technical University of Munich","place":["Munich, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vicki-Marie","family":"Butenschoen","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, TUM Klinikum, Technical University of Munich","place":["Munich, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,16]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1007\/s40618-018-0901-5","article-title":"Advances and controversies in the classification and grading of pituitary tumors","volume":"42","author":"Laws","year":"2019","journal-title":"J Endocrinol Investig"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"4769","DOI":"10.1210\/jc.2006-1668","article-title":"High prevalence of pituitary adenomas: a cross-sectional study in the province of Liege, Belgium","volume":"91","author":"Daly","year":"2006","journal-title":"J Clin Endocrinol 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