{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T15:06:35Z","timestamp":1784646395150,"version":"3.55.0"},"reference-count":32,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T00:00:00Z","timestamp":1784592000000},"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>Background and objectives<\/jats:title>\n                    <jats:p>Non-functioning pituitary adenomas (NFPAs) are among the most common pituitary tumors, accounting for approximately 22\u201354% of all pituitary adenomas. Although histologically benign, NFPAs can cause considerable morbidity and mortality due to their potential to induce endocrine disturbances. Endoscopic transsphenoidal surgery (eTSS) is the preferred treatment modality; however, postoperative hypopituitarism-particularly adrenal insufficiency-is frequent, necessitating long-term glucocorticoid therapy. Determining the optimal glucocorticoid dosage remains a significant clinical challenge. This study aimed to identify independent predictors of postoperative glucocorticoid therapy intensity in NFPA patients by integrating imaging and endocrinological parameters, and to develop a predictive model that supports individualized glucocorticoid replacement therapy and optimizes clinical decision-making.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective analysis included 116 patients who underwent pituitary adenoma resection between March 2019 and December 2024. Demographic, clinical, radiological, endocrinological, and pathological data were collected. Imaging assessments included tumor volume, pituitary stalk stretch, and suprasellar extension measured using 3D Slicer software. Preoperative serum cortisol and ACTH levels were determined. Multivariate regression analysis was performed to identify independent predictors of postoperative glucocorticoid therapy intensity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Tumor volume, suprasellar extension, pituitary stalk stretch, and preoperative morning cortisol levels were identified as independent predictors of glucocorticoid therapy intensity (all\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.05), collectively explaining 72.1% of the variance (adjusted\n                      <jats:italic>R<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u202f=\u202f0.721). Bootstrap resampling confirmed model robustness (RMSE: 656.04; 95% CI: 637.50\u2013690.22).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Tumor volume, suprasellar extension, pituitary stalk stretch, and morning cortisol level are key determinants of postoperative glucocorticoid therapy intensity in NFPA patients. The proposed model provides an evidence-based tool to optimize postoperative care, potentially reducing the risk of adrenal insufficiency and overtreatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2026.1806623","type":"journal-article","created":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T14:56:47Z","timestamp":1784645807000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Predictors of glucocorticoid treatment intensity after endoscopic transsphenoidal surgery in patients with non-functional pituitary adenomas: a retrospective study"],"prefix":"10.3389","volume":"17","author":[{"given":"Mengzhen","family":"Yu","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University","place":["Xiamen, Fujian, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chen","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Xiamen Xianyue Hospital, Xianyue Hospital Affiliated with Xiamen Medical College, Fujian Psychiatric Center, Fujian Clinical Research Center for Mental Disorders","place":["Xiamen, Fujian, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yukui","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University","place":["Xiamen, Fujian, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinli","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Reproduction, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University","place":["Xiamen, Fujian, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhangyu","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University","place":["Xiamen, Fujian, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janyao","family":"Mao","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University","place":["Xiamen, Fujian, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wanting","family":"Qi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University","place":["Xiamen, Fujian, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ping","family":"Zhong","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University","place":["Xiamen, Fujian, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sifang","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University","place":["Xiamen, Fujian, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guowei","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University","place":["Xiamen, Fujian, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wentao","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University","place":["Xiamen, Fujian, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xi","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University","place":["Xiamen, Fujian, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,21]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1677\/erc.0.0070029","article-title":"The epidemiology of endocrine tumours","volume":"7","author":"Monson","year":"2000","journal-title":"Endocr Relat 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in patients with non-functional pituitary macroadenomas: a single Centre retrospective cohort study","volume":"82","author":"Hussein","year":"2023","journal-title":"Endocrine"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"843","DOI":"10.1007\/s10143-021-01617-y","article-title":"Predictors of visual and endocrine outcomes after endoscopic transsphenoidal surgery for pituitary adenomas","volume":"45","author":"Castle-Kirszbaum","year":"2022","journal-title":"Neurosurg Rev"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"1142","DOI":"10.3171\/2018.5.JNS181054","article-title":"Endocrine function and gland volume after endoscopic transsphenoidal surgery for nonfunctional pituitary macroadenomas","volume":"131","author":"Harary","year":"2018","journal-title":"J Neurosurg"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"1269","DOI":"10.1227\/neu.0000000000002360","article-title":"Correlation of pituitary descent and diabetes insipidus after Transsphenoidal pituitary macroadenoma resection","volume":"92","author":"Ma","year":"2023","journal-title":"Neurosurgery"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"837","DOI":"10.1007\/s12020-024-03835-y","article-title":"Clinical and radiographic characteristics of patients with non-functioning pituitary adenomas categorized according to their serum prolactin concentration: novel predictors of postoperative transient diabetes insipidus following surgery","volume":"85","author":"Sakata","year":"2024","journal-title":"Endocrine"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"949","DOI":"10.1093\/neuros\/nyaa148","article-title":"Diabetes insipidus after endoscopic transsphenoidal surgery","volume":"87","author":"Burke","year":"2020","journal-title":"Neurosurgery"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"e220187","DOI":"10.1530\/EC-22-0187","article-title":"Change in the pituitary stalk deviation angle after transsphenoidal surgery can 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