Abstract
Objective This paper aims to analyze the risk factors for the recurrence or progression of nonfunctioning pituitary adenomas (NFPAs) in male patients after transnasal sphenoidal surgery and to develop a predictive model for prognosis.
Method Clinical and follow-up data of 126 male patients with NFPAs treated by transnasal sphenoidal surgery from January 2011 to January 2021 in Fuzhou 900th Hospital were retrospectively analyzed. Basic clinical information (age), imaging features (tumor size, modified Knosp grading, and resection extent), and histopathological features (Ki-67) were retrieved to construct a nomogram prediction model and to validate its performance.
Result Out of 126 cases, 7 (5.56%) showed postoperative tumor recurrence, and 18 (14.29%) exhibited postoperative residual regrowth (progression). Age (P=0.024), maximum tumor diameter (P<0.001), modified Knosp grade (P<0.001), resection extent (P<0.001), and Ki67 (P＜0.001) were statistically significant between the recurrence group, the progression group, and the alleviate group. Three independent risk factors (modified Knosp classification, resection extent, and Ki67) affecting postoperative remission were used to construct a predictive model for long-term postoperative failure to remit. In addition, the nomogram and ROC curve based on the above results indicated significant clinical value.
Conclusion A nomogramprediction model based on modified Knosp grading (grades 3B-4), resection extent (partial resection), and Ki-67 (≥3%) predicts the recurrence or progression of NFPAs in men after transnasal sphenoidal surgery.