Retrospective Validation of the Zurich Pituitary Score (ZPS) for Resection of Pituitary Adenomas Marianne Ruelle 1Donald
1 B.Sc. ,
Timothy G White
2 MD ,
Danielle Golub
2 MD ,
Amir R Dehdashti
2 MD
and Barbara Zucker School of Medicine at Hofstra/Northwell, 2Department of Neurosurgery, North Shore University Hospital, Northwell Health, Manhasset, NY, USA
Background
Methods
Pituitary macroadenoma tumors can cause mass effect on critical neural structures and/or hormonal hypersecretion; surgical resection for the purpose of gross total resection (GTR) is the standard treatment. The Knosp classification, a radiological grading system of pituitary lesions, has been widely adopted by surgeons and radiologists to predict surgical outcomes. However, this score is not quantitative, and has been shown to demonstrate poor inter rater reliability. Recently, a simple quantitative rating system has been developed, the Zurich Pituitary Score. It has predictive ability for gross total resection post transsphenoidal pituitary surgery. However, this score has only been validated in a limited setting, so the generalizability of its predictive analytics remains unknown. We are thus performing a retrospective validation of the Zurich Pituitary Score in patients who underwent transsphenoidal surgery for pituitary adenoma at Northwell Health.
A retrospective chart review of all patients who underwent endoscopic transsphenoidal surgery for pituitary adenoma at Northwell Health over the last 8 years was performed. Zurich Pituitary Scores, data on gross total resection, extent of resection, and additional tumor dimensions were obtained for all patients. A statistical analysis of the trends observed over the four ZPS grades is currently being completed for 192 patients.
Objectives The aim of the study is to externally validate the Zurich Pituitary Score (ZPS).
Future Direction This proposed score is a simple tool with predictive ability for surgical outcomes of patients undergoing transsphenoidal surgery for pituitary adenomas. We hope that after external validation, it can be used more widely as an alternative to the Knosp classification.
Selected References Knosp, E., et al., Pituitary adenomas with invasion of the cavernous sinus space: a magnetic resonance imaging classification compared with surgical findings. Neurosurgery, 1993. 33(4): p. 610-7; discussion 617-8. Figure 7: Independent CRISPR knockout of CDK4 or CDK6 does not cause dropout in most breast cancer cell lines studied.
R, ratio of maximum horizontal tumor diameter divided by the minimum intercarotid distance at the intracavernous horizontal C4 segment of the ICA
Serra, C., et al., Predicting extent of resection in transsphenoidal surgery for pituitary adenoma. Acta Neurochir (Wien), 2018. 160(11): p. 2255-2262.