{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T12:46:17Z","timestamp":1789562777020,"version":"build-2803163510"},"reference-count":51,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2021,7,18]],"date-time":"2021-07-18T00:00:00Z","timestamp":1626566400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Purpose: To evaluate factors influencing clinical and radiological outcome of extended endoscopic endonasal transtuberculum\/transplanum approach (EEA-TTP) for giant pituitary adenomas (GPAs). Methods: We recruited prospectively all consecutive GPAs patients undergoing EEA-TTP between 2015 and 2019 in 5 neurosurgical centers. Preoperative clinical and radiologic features, visual and hormonal outcomes, extent of resection (EoR), complications and recurrence rates were recorded and analyzed. Results: Of 1169 patients treated for pituitary adenoma, 96 (8.2%) had GPAs. Seventy-eight (81.2%) patients had visual impairment, 12 (12.5%) had headaches, 3 (3.1%) had drowsiness due to hydrocephalus, and 53 (55.2%) had anterior pituitary insufficiency. EoR was gross or near-total in 46 (47.9%) and subtotal in 50 (52.1%) patients. Incomplete resection was associated with lateral suprasellar, intraventricular and\/or cavernous sinus extension and with firm\/fibrous consistence. At the last follow-up, all but one patient (77, 98.7%) with visual deficits improved. Headache improved in 8 (88.9%) and anterior pituitary function recovered in 27 (50.9%) patients. Recurrence rate was 16.7%, with 32 months mean recurrence-free survival. Conclusions: EEA-TTP is a valid option for GPAs and seems to provide better outcomes, lower rate of complications and higher EoR compared to one- or multi-stage microscopic, non-extended endoscopic transsphenoidal, and transcranial resections.<\/jats:p>","DOI":"10.3390\/cancers13143603","type":"journal-article","created":{"date-parts":[[2021,7,18]],"date-time":"2021-07-18T21:16:48Z","timestamp":1626643008000},"page":"3603","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":50,"title":["Primary Endoscopic Endonasal Management of Giant Pituitary Adenomas: Outcome and Pitfalls from a Large Prospective Multicenter Experience"],"prefix":"10.3390","volume":"13","author":[{"given":"Salvatore","family":"Chibbaro","sequence":"first","affiliation":[{"name":"Neurosurgery Unit, Hautepierre Regional Hospital, Strasbourg University, 67200 Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5040-1916","authenticated-orcid":false,"given":"Francesco","family":"Signorelli","sequence":"additional","affiliation":[{"name":"Neurosurgery Unit, Department of Basic Medical Sciences, Neurosciences, Sense Organs, University \u201cAldo Moro\u201d, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davide","family":"Milani","sequence":"additional","affiliation":[{"name":"Neurosurgery Unit, Humanitas Research Hospital, 20089 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helene","family":"Cebula","sequence":"additional","affiliation":[{"name":"Neurosurgery Unit, Hautepierre Regional Hospital, Strasbourg University, 67200 Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonino","family":"Scibilia","sequence":"additional","affiliation":[{"name":"Neurosurgery Unit, Hautepierre Regional 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Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julien","family":"Todeschi","sequence":"additional","affiliation":[{"name":"Neurosurgery Unit, Hautepierre Regional Hospital, Strasbourg University, 67200 Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene","family":"Ollivier","sequence":"additional","affiliation":[{"name":"Neurosurgery Unit, Hautepierre Regional Hospital, Strasbourg University, 67200 Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"Mallereau","sequence":"additional","affiliation":[{"name":"Neurosurgery Unit, Hautepierre Regional Hospital, Strasbourg University, 67200 Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guillaume","family":"Dannhoff","sequence":"additional","affiliation":[{"name":"Neurosurgery Unit, Hautepierre Regional Hospital, Strasbourg University, 67200 Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Romano","sequence":"additional","affiliation":[{"name":"Neurosurgery Department, Parma and Reggio Emilia Hospital, University of Parma, 43126 Parma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Cammarota","sequence":"additional","affiliation":[{"name":"Neurosurgery Unit, Hautepierre Regional Hospital, Strasbourg University, 67200 Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franco","family":"Servadei","sequence":"additional","affiliation":[{"name":"Neurosurgery Unit, Humanitas Research Hospital, 20089 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4417-1496","authenticated-orcid":false,"given":"Raoul","family":"Pop","sequence":"additional","affiliation":[{"name":"Neurosurgery Unit, Hautepierre Regional Hospital, Strasbourg University, 67200 Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seyyid","family":"Baloglu","sequence":"additional","affiliation":[{"name":"Neurosurgery Unit, Hautepierre Regional Hospital, Strasbourg University, 67200 Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Lasio","sequence":"additional","affiliation":[{"name":"Neurosurgery Unit, Humanitas Research Hospital, 20089 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florina","family":"Luca","sequence":"additional","affiliation":[{"name":"Endocrinology Unit, Hautepierre Regional Hospital, Strasbourg University, 67200 Strasbourg, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernard","family":"Goichot","sequence":"additional","affiliation":[{"name":"Endocrinology Unit, Hautepierre Regional Hospital, Strasbourg University, 67200 Strasbourg, 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