Multicenter external validation of the Zurich Pituitary Score
| Autor: | Elena d'Avella, Matteo Zoli, Domenico Solari, Fabio Pozzi, Diego Mazzatenta, Davide Locatelli, Luigi Maria Cavallo, Carlo Serra, Luca Regli, Victor E. Staartjes |
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| Přispěvatelé: | University of Zurich, Staartjes, Victor E, Staartjes V.E., Serra C., Zoli M., Mazzatenta D., Pozzi F., Locatelli D., D'Avella E., Solari D., Cavallo L.M., Regli L., Staartjes, V. E., Serra, C., Zoli, M., Mazzatenta, D., Pozzi, F., Locatelli, D., D'Avella, E., Solari, D., Cavallo, L. M., Regli, L. |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Adenoma
Adult Male Extent of resection External validation Gross total resection Outcome prediction Pituitary adenoma Zurich Pituitary Score Neoplasm Residual Intraclass correlation Classification scheme 610 Medicine & health Neurosurgical Procedure Neurosurgical Procedures 030218 nuclear medicine & medical imaging 03 medical and health sciences 10180 Clinic for Neurosurgery 0302 clinical medicine Humans Medicine Pituitary Neoplasms Pituitary Neoplasm Aged Neoplasm Staging business.industry Endoscopy Middle Aged medicine.disease Gross Total Resection Quantitative classification Tumor Burden 2746 Surgery Treatment Outcome 2728 Neurology (clinical) Surgery Female Neurology (clinical) business Pituitary surgery Nuclear medicine 030217 neurology & neurosurgery Human |
| DOI: | 10.5167/uzh-187470 |
| Popis: | Purpose: Recently, the Zurich Pituitary Score (ZPS) has been proposed as a new quantitative preoperative classification scheme for predicting gross total resection (GTR), extent of resection (EOR), and residual tumor volume (RV) in endoscopic pituitary surgery. We evaluated the external validity of the ZPS. Methods: In three reference centers for pituitary surgery, the ZPS was applied and correlated to GTR, EOR, and RV. Furthermore, its inter-rater agreement was assessed. Results: A total of 485 patients (53% male; age, 53.8 ± 15.7) were included. ZPS grades I, II, III, and IV were observed in 110 (23%), 270 (56%), 64 (13%), and 41 (8%) patients, respectively. GTR was achieved in 358 (74%) cases, with mean EOR of 87.6% ± 20.3% and RV of 1.42 ± 2.80cm3. With increasing ZPS grade, strongly significant decreasing trends for GTR (I, 92%; II, 77%; III, 67%; IV, 15%; p < 0.001) and EOR (I, 93.8%; II, 89.9%; III, 88.1%; IV, 75.4%; p < 0.001) were found. Similarly, RV increased steadily ([cm3] I, 0.16; II, 0.61; III, 2.01; IV, 3.84; p < 0.001). We observed intraclass correlation coefficients of 0.837 (95% CI, 0.804–0.865) for intercarotid distance and 0.964 (95% CI, 0.956–0.970) for adenoma diameter, and Cohen’s kappa of 0.972 (95% CI, 0.952–0.992) for the ZPS grades. Conclusions: Application of the ZPS in three external cohorts was successful. The ZPS generalized well in terms of GTR, EOR, and RV; demonstrated excellent inter-rater agreement; and can safely and effectively be applied as a quantitative classification of adenomas with relevance to surgical outcome. |
| Databáze: | OpenAIRE |
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