Advancing Evidence Quality and Reproducibility in Endoscopic Endonasal Surgery for Pituitary Neuroendocrine Tumors: A Systematic Review and Reporting Guideline.

Authors

Rudolfh Batista Arend, Miguel Garcia, Kelvin Brian Tapia Borges, Bruno Zilli Peroni, Natan Lucca Lima, Daniel Eduardo Oliveira Gomes, Leonardo Januario Campos Cardoso, Marcio Yuri Ferreira, Herika Negri Brito, Antonio Delacy Martini Vial, Cleiton Formentin, Matteo De Notaris, Edoardo Agosti, Alex Roman, Guilherme Gago, Ricardo Ramina, Gustavo Jung

Published in

World neurosurgery. Pages 125402. Oct 09, 2026. Epub Oct 09, 2026.

Abstract

Endoscopic endonasal surgery (EES) is the primary approach for pituitary neuroendocrine tumors (PitNET); however, outcome reporting remains heterogeneous and inconsistent, limiting reproducibility, comparability, and evidence synthesis. We aimed to assess the reporting quality in EES-for-PitNET studies and develop a dedicated Reporting guideline.
PubMed, Embase, Scopus, and Web of Science were systematically searched from inception to January 27, 2026. Original clinical studies (≥10 patients) reporting clinical, surgical, endocrinological, radiological, perioperative, or follow-up outcomes after endoscopic endonasal/transsphenoidal/transnasal surgery for PitNET were included. The reporting quality was assessed across nine domains: baseline characteristics, imaging and tumor features, definitions of key concepts, team characteristics, anesthetic protocol, surgical details, outcomes and adverse events, retreatment, and funding/conflicts of interest.
Thirty study-records comprising approximately 15,800 patients were included. Reporting deficiencies were identified across all domains. Age (93%) and sex (100%) were almost universally reported and the treatment modality was always defined (100%); however, comorbidities were fully detailed in only 10%, and a comprehensive anesthetic protocol was essentially absent (3%). Key terms were defined in 53%, intraoperative adverse-event classification in 17%, and all-cause and procedure-related mortality criteria in 0%. Surgeon's experience was reported in 63%, time from symptom onset to treatment in 3%, and retreatment frequency and indications in 17% and 27%, respectively. Based on these gaps we developed the Endoscopic Endonasal Pituitary Neuroendocrine Tumor Reporting Guideline.
EES-for-PitNET literature demonstrates substantial reporting deficiencies that limit evidence reliability and synthesis. The proposed Reporting Guideline provides a structured framework to improve transparency, reproducibility, and comparability in future studies.

PMID:
42854959
Bibliographic data and abstract were imported from PubMed on 10 Oct 2026.

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