Top

Published in:

Open Access 01-10-2017 | Pituitary Society Position Statement

Criteria for the definition of Pituitary Tumor Centers of Excellence (PTCOE): A Pituitary Society Statement

Authors: Felipe F. Casanueva, Ariel L. Barkan, Michael Buchfelder, Anne Klibanski, Edward R. Laws, Jay S. Loeffler, Shlomo Melmed, Pietro Mortini, John Wass, Andrea Giustina, On behalf of The Pituitary Society, Expert Group on Pituitary Tumors

Published in: Pituitary | Issue 5/2017

Abstract

Introduction

With the goal of generate uniform criteria among centers dealing with pituitary tumors and to enhance patient care, the Pituitary Society decided to generate criteria for developing Pituitary Tumors Centers of Excellence (PTCOE).

Methods

To develop that task, a group of ten experts served as a Task Force and through two years of iterative work an initial draft was elaborated. This draft was discussed, modified and finally approved by the Board of Directors of the Pituitary Society. Such document was presented and debated at a specific session of the Congress of the Pituitary Society, Orlando 2017, and suggestions were incorporated. Finally the document was distributed to a large group of global experts that introduced further modifications with final endorsement.

Results

After five years of iterative work a document with the ideal criteria for a PTCOE is presented.

Conclusions

Acknowledging that very few centers in the world, if any, likely fulfill the requirements here presented, the document may be a tool to guide improvements of care delivery to patients with pituitary disorders. All these criteria must be accommodated to the regulations and organization of Health of a given country.

Daly AF, Tichomirowa MA, Beckers A (2009) The epidemiology and genetics of pituitary adenomas. Best Pract Res Clin Endocrinol Metab 23:543–554CrossRef

Fernandez A, Karavitaki N, Wass JA (2010) Prevalence of pituitary adenomas: a community-based, cross-sectional study in Banbury (Oxfordshire, UK). Clin Endocrinol 72:377–82CrossRef

Giustina A, Chanson P, Kleinberg D et al (2014) Expert consensus document: A consensus on the medical treatment of acromegaly. Nat Rev Endocrinol 10:243–248CrossRef

Melmed S, Casanueva FF, Cavagnini F et al (2002) Guidelines for acromegaly management. J Clin Endocrinol Metab 87:4054–4058CrossRef

Barker FG, Klibanski A, Swearingen B (2003) Transsphenoidal surgery for pituitary tumors in the United States, 1996–2000: mortalitiy, morbidity, and the effects of hospital and surgeon volume. J Clin Endocrinol Metab 88:4709–4719CrossRef

Weisman CS, Squires GL (2000) Women’s health centers: are the national centers of excellence in women’s health a new model? Womens Health Issues 10:248–255CrossRef

Champion JK, Pories WJ (2005) Centers of excellence for bariatric surgery. Surg Obes Relat Dis 1:148–151CrossRef

Pratt GM, McLees B, Pories WJ (2006) The ASBS bariatric surgery centers of excellence program: a blueprint for quality improvement. Surg Obes Relat Dis 2:497–503CrossRef

McLaughlin N, Laws ER, Oyesiku NM et al (2012) Pituitary centers of excellence. Neurosurgery 71:916–924CrossRef

10.

Swearingen B (2012) Update on pituitary surgery. J Clin Endocrinol Metab 97:1073–1081CrossRef

11.

Luft HS, Bunker JP, Enthoven AC (1979) Should operations be regionalized? The empirical relation between surgical volume and mortality. N Engl J Med 301:1364–1369CrossRef

12.

Schwartz TH (2013) A role for centers of excellence in transsphenoidal surgery. World Neurosurgery 80:270–271CrossRef

13.

Mercado M, Gonzalez B, Vargas G et al (2014) Successful mortality reduction and control of comorbidities in patients with acromegaly followed at a highly specialized multidisciplinary clinic. J Clin Endocrinol Metab 99:4438–4446CrossRef

14.

Faustini-Fustini M, Pasquini E, Zoli M et al (2013) Pituitary centers of excellence. Neurosurgery 73:557–558CrossRef

15.

Knutzen R (2014) Pituitary centers of excellence: for patients it is life or death. Neurosurgery 74:143–144CrossRef

16.

Koc K, Anik I, Ozdamar D et al (2006) The learning curve in endoscopic pituitary surgery and our experience. Neurosurg Rev, 29, 298–305CrossRef

17.

Snyderman C, Kassam A, Carrau R et al (2007) Acquisition of surgical skills for endonasal skull base surgery: a training program. Laryngoscope 117:699–705CrossRef

18.

Lee TT, Klose JL, Congress of Neurological Surgeons Education Committee (1999) Survey on neurosurgery subspecialty fellowship training. Surg Neurol 52:641–644CrossRef

19.

Yamada S, Aiba T, Takada K et al (1996) Retrospective analysis of long-term surgical results in acromegaly: preoperative and postoperative factors predicting outcome. Clin Endocrinol 45:291–298CrossRef

20.

Gittoes NJ, Sheppard MC, Johnson AP et al (1999) Outcome of surgery for acromegaly—the experience of a dedicated pituitary surgeon. Q J Med 92:741–745CrossRef

21.

Erturk E, Tuncel E, Kiyici S et al (2005) Outcome of surgery for acromegaly performed by different surgeons: importance of surgical experience. Pituitary 8:93–97CrossRef

22.

Bates PR, Carson MN, Trainer PJ et al (2008) Wide variation in surgical outcomes for acromegaly in the UK. Clin Endocrinol 68:136–142CrossRef

23.

Shahlalie K, McLaughlin N, Kassam AB et al (2010) The role of outcomes data for assessing the expertise of a pituitary surgeon. Curr Opin Endocrinol Diabetes Obes 17:369–376CrossRef

24.

Ciric I, Ragin A, Baumgartner C et al (1997) Complications of transsphenoidal surgery: results of a national survey, review of the literature, and personal experience. Neurosurgery 40:225–236CrossRef

25.

Fatemi N, Dusick JR, de Paiva Neto MA et al (2008) The endonasal microscopic approach for pituitary adenomas and other parasellar tumors: a 10-year experience. Neurosurgery 63:244–256CrossRef

26.

Laws ER, Fode NC, Redmond MJ (1985) Transsphenoidal surgery following unsuccessful prior therapy. An assessment of benefits and risks in 158 patients. J Neurosurg 63:823–829CrossRef

27.

Mattozo CA, Dusick JR, Esposito F et al (2006) Suboptimal sphenoid and sellar exposure: a consistent finding in patients treated with repeat transsphenoidal surgery for residual endocrine-inactive macroadenomas. Neurosurgery 58:857–865CrossRef

28.

Saeki N, Yamaura A, Numata T et al (1999) Transsphenoidal reoperations for removal of pituitary adenomas: rhinological management and timing of reoperation. J Clin Neurosci 6:385–388CrossRef

29.

Ahmed S, Elsheikh M, Stratton IM et al (1999) Outcome of transsphenoidal surgery for acromegaly and its relationship to surgical experience. Clin Endocrinol 50:561–567CrossRef

30.

Birkmeyer JD, Siewers AE, Finlayson EV et al (2002) Hospital volume and surgical mortality in the United States. N Engl J Med 346:1128–1137CrossRef

31.

Barker FG, Curry WT Jr, Carter BS (2005) Surgery for primary supratentorial brain tumors in the United States, 1988 to 2000: the effect of provider case load and centralization of care. Neuro Oncol 7:49–63CrossRef

32.

Jane JA, Laws ER (2001) The surgical management of pituitary adenomas in a series of 3,093 patients. J Am Coll Surg 193:651–659CrossRef

33.

Wilson CB (1997) Surgical management of pituitary tumors. J Clin Endocrinol Metab 82:2381–2385CrossRef

34.

Powell M, Grossman A (2016) Quality indicators in pituitary surgery: a need for reliable and valid assessment. What should be measured? Clin Endo 84:485–488CrossRef

35.

Ammirati M, Wei L, Ciric I (2013) Short-term outcome of endoscopic versus microscopic pituitary adenoma surgery: a systematic review and meta-analysis. J Neurol Neurosurg Psychiatry 84:843–849CrossRef

36.

Ascoli P, Cavagnini F et al (2006) Hypopituitarism Pituitary 9:335–342CrossRef

37.

Casanueva FF, Molitch ME, Schlechte JA et al (2006) Guidelines of the Pituitary Society for the diagnosis and management of prolactinomas. Clin Endocrinol 65:265–273CrossRef

38.

Maffezzoni F, Formenti AM, Mazziotti G et al (2016) Current and future medical treatments for patients with acromegaly. Expert Opin Pharmacother 17:1631–1642CrossRef

39.

Evans CO, Young AN, Brown MR et al (2001) Novel patterns of gene expression in pituitary adenomas identifiied by complementary deoxyribonucleic acid microarryas and quantitative RT-PCR. J Clin Endocrinol Metab 86:3097–3107PubMed

40.

Kontogeorgos G (2005) Classification and pathology of pituitary tumors. Endocr 28:27–35CrossRef

41.

Moreno CS, Evans CO, Zhan X et al (2005) Novel molecular signaling and classification in human clinically non-functional pituitary adenomas identified by gene expression profiling and proteomics analyses. Cancer Res 65:10214–10222CrossRef

42.

Saeger W, Lüdecke DK, Buchfelder M et al (2007) Pathohistological classification of pituitary tumors: 10 years of experience with the German Pituitary Tumor Registry. Eur J Endocrinol 156:203–216CrossRef

43.

O’Malley BW, Grady MS, Gabel BC et al (2008) Comparison of endoscopic and microscopic removal of pituitary adenomas: single-surgeon experience and the learning curve. Neurosurg Focus 25:E10CrossRef

44.

Gejman R, Swearingen B, Hedley-Whyte ET et al (2008) Role of Ki-67 proliferation index and p53 expression in predicting progression of pituitary adenomas. Hum Pathol 39:758–766CrossRef

45.

Galland F, Lacroix L, Saulnier P et al (2010) Differential gene expression profiles of invasive and non-invasive non-functioning pituitary adenomas base on microarray analysis. Endoc Relat Cancer 17:361–371CrossRef

46.

Bush ZM, Longtine JA, Cunningham T et al (2010) Temozolomide treatment for aggressive ppituitary tumors: correlation of clinical outcome with O(6)-methylguanine methyltransferase (MGMT) promoter methylation and expression. J Clin Endocrinol Metab 95:280–290CrossRef

47.

Salehi F, Agur A, Scheithauer BW et al (2010) Biomarkers of pituitary neoplasms: a review (Part II). Neurosurgery 67:1790–1798CrossRef

48.

Sheehan JM, Vance ML, Sheehan JP et al (2000) Radiosurgery for Cushing’s disease after failed transsphenoidal surgery. J Neurosrug 93:738–745

49.

Jane JA, Vance ML, Woodburn CJ et al (2003) Stereotactic radiosurgery for hypersecreting pituitary tumors: part of a multimodality approach. Neurosurg Focus, 14:e12CrossRef

50.

Behbehani RS, McElveen T, Sergott RC et al (2005) Frationated stereotactic radiotherapy for parasellar meningiomas: a preliminary report of visual outcomes. Br J Ophthalmol 89:130–133CrossRef

51.

Melmed S, Colao A, Barkan A et al (2009) Guidelines for acromegaly management: an update. J Clin Endocrinol Metab 94:1509–1517CrossRef

52.

Jensen R, O’Rourke D, Warnick R et al (2006) Resident training in neurosurgical oncology: results of the survey of North American training programs by the AANS/CNS Section on Tumors. J Neurooncol 77:241–246CrossRef

53.

McLaughlin N, Kassam AB, Prevedello DM et al (2011) Management of Cushing’s disease after failed surgery-a review. Can J Neurol Sci 38:12–21CrossRef

54.

Loeffler JS, Shih HS (2011) Radiation therapy in the management of pituitary adenomas. J Clin Endocrinol Metab 96:1992–2003CrossRef

55.

Shrieve DC,Loeffler JS (2010) Human radiation injury. Lippincott Williams and Wilkins, Philadelphia, p 560

56.

Mortini P, Losa M, Barzaghi R et al (2005) Results of transsphenoidal surgery in a large series of patients with pituitary adenoma. Neurosurgery 56:1222–1233CrossRef

57.

Burman P, van Beek AP, Biller M.K.B. et al (2017) Radiotherapy, especially at young age, increases the risk for de novo brain tumors in patients treated for pituitary/sellar lesions. J Clin Endocrinol Metab 102:1051–1058PubMed

Title: Criteria for the definition of Pituitary Tumor Centers of Excellence (PTCOE): A Pituitary Society Statement
Authors: Felipe F. Casanueva
Ariel L. Barkan
Michael Buchfelder
Anne Klibanski
Edward R. Laws
Jay S. Loeffler
Shlomo Melmed
Pietro Mortini
John Wass
Andrea Giustina
On behalf of The Pituitary Society, Expert Group on Pituitary Tumors
Publication date: 01-10-2017
Publisher: Springer US
Published in: Pituitary / Issue 5/2017
Print ISSN: 1386-341X
Electronic ISSN: 1573-7403
DOI: https://doi.org/10.1007/s11102-017-0838-2

ACC 2024 Congress Coverage

Heart Failure Video

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Criteria for the definition of Pituitary Tumor Centers of Excellence (PTCOE): A Pituitary Society Statement

Abstract

Introduction

Methods

Results

Conclusions

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 5/2017

Best candidates for dopamine agonist withdrawal in patients with prolactinomas

Pituitary dysfunction in granulomatosis with polyangiitis

Visual outcomes after endoscopic endonasal pituitary adenoma resection: a systematic review and meta-analysis

Erratum to: Acromegaly: surgical results in 548 patients

Cross-sectional prevalence of pancreatic cystic lesions in patients with acromegaly, a single-center experience

Genetic analysis of IRF6, a gene involved in craniofacial midline formation, in relation to pituitary and facial morphology of patients with idiopathic growth hormone deficiency

ACC 2024 Congress Coverage

Year in Review: Heart failure and cardiomyopathies

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

Incentivised to exercise

New intervention for STEMI-related cardiogenic shock

» View more highlights on the ACC 2024 congress hub page