Lyu Wen, Fei Xu, Chen Cheng, Tang Yuqun
Department of Neurosurgery, Shenzhen People's Hospital, Second Clinical Medical College of Jinan University, Shenzhen, China.
Department of Neurosurgery, First Affiliated Hospital of Southern University of Science and Technology, Shenzhen, China.
Gland Surg. 2021 Feb;10(2):807-815. doi: 10.21037/gs-21-47.
To analyze and predict the possibility of post-operative recurrence in non-functioning pituitary adenoma (NFPA) patients, we investigated the clinical factors leading to tumor recurrence and built a nomogram predictive model based on these risk factors.
A single-center retrospective study was performed. A total of 145 NFPA patients who underwent surgical treatment at Shenzhen People's Hospital from September 2013 to January 2019 were selected. Among them, 52 patients were diagnosed with recurrence of NFPA according to follow-up investigations. Binary logistic regression analysis was used to determine the significant risk factors. A nomogram model was then built to predict recurrence using these factors.
The univariate analysis and the binary logistic regression analysis showed that age, tumor size, cavernous invasion, sphenoid sinus invasion, and surgical extension were significant factors affecting tumor recurrence. We then built a nomogram model to predict post-operative recurrence in NFPA patients using these factors. The correlation analysis indicated that sphenoid sinus invasion [hazard ratio (HR) =13.14, 95% confidence interval (CI): 7.03-24.58, P<0.0001], cavernous sinus invasion (HR =7.53, 95% CI: 4.27-13.28, P<0.0001), and tumor size (HR =11.06, 95% CI: 6.11-20.03, P<0.0001) could promote the recurrence of NFPA. In contrast, advanced age (HR =0.50, 95% CI: 0.28-0.86, P<0.0001) and gross total resection (HR =0.12, 95% CI: 0.07-0.22, P<0.0001) could effectively inhibit recurrence.
In this study, we developed a nomogram predictive model based on the significant recurrence-associated factors for NFPA. This nomogram may aid neurosurgeons in the post-operative prediction of recurrence, and may facilitate tailored counseling of individual patients.
为了分析和预测无功能垂体腺瘤（NFPA）患者术后复发的可能性，我们研究了导致肿瘤复发的临床因素，并基于这些危险因素建立了一个列线图预测模型。
进行了一项单中心回顾性研究。选取了2013年9月至2019年1月在深圳市人民医院接受手术治疗的145例NFPA患者。其中，52例患者经随访调查诊断为NFPA复发。采用二元逻辑回归分析确定显著危险因素。然后使用这些因素建立列线图模型来预测复发。
单因素分析和二元逻辑回归分析表明，年龄、肿瘤大小、海绵窦侵犯、蝶窦侵犯和手术范围是影响肿瘤复发的显著因素。然后，我们使用这些因素建立了一个列线图模型来预测NFPA患者的术后复发。相关性分析表明，蝶窦侵犯[风险比（HR）=13.14，95%置信区间（CI）：7.03 - 24.58，P<0.0001]、海绵窦侵犯（HR =7.53，95%CI：4.27 - 13.28，P<0.0001）和肿瘤大小（HR =11.06，95%CI：6.11 - 20.03，P<0.0001）可促进NFPA复发。相反，高龄（HR =0.50，95%CI：0.28 - 0.86，P<0.0001）和全切（HR =0.12，95%CI：0.07 - 0.22，P<0.0001）可有效抑制复发。
在本研究中，我们基于NFPA复发相关的显著因素开发了一个列线图预测模型。该列线图可能有助于神经外科医生对术后复发进行预测，并有助于为个体患者提供个性化的咨询。
