Microscopic trans-sphenoidal adenomectomy | Endoscopic transsphenoidal adenomectomy | Tested difference (95% CI; p-value) | Tested difference (95% CI; p-value) (Microadenoma only) | Tested difference (95% CI; p-value) (Macroadenoma only) | |||
---|---|---|---|---|---|---|---|
N | % | N | % | ||||
Total | 87 | 100.0 | 50 | 100.0 | Sample size:103 | Sample size:34 | |
Age at diagnosis, years* | 38.9 | 15.4 | 44.4 | 15.1 | 5.5 (0.1 to 10.9; p = 0.045) | 3.4 (−2.6 to 9.3; p = 0.263) | 9.0 (−3.5 to 21.4; p = 0.152) |
Sex (female) | 69 | 79.3 | 34 | 68.0 | 11.3 (−4.2 to 26.8; p = 0.140) | 7.7 (− 10.4 to 25.8; p = 0.391) | 20.8 (−8.5 to 50.1; p = 0.170) |
Calendar year of transsphenoidal surgery° | 1992 | 1978–2005 | 2011 | 2003–2016 | 19.2 (17.1 to 21.2; p = 0.000) | 20.4 (18.1 to 22.6; p = 0.000) | 14.7 (10.1 to 19.3; p = 0.000) |
Duration of follow-up (years) $ | 16.9 | 11.7–26.7 | 4.7 | 2.0–7.4 | 13.4 (11.0 to 15.8; p = 0.000) | 14.0 (11.2 to 17.7; p = 0.000) | 11.3 (6.9 to 15.6; p = 0.000) |
Comorbidities at diagnosis | |||||||
Hypertension | 64 | 73.6 | 38 | 76.0 | 2.4 (− 12.6 to 17.4; p = 0.756) | 3.3 (−15.2 to 21.8; p = 0.723) | 15.3 (− 11.0 to 41.6; p = 0.271) |
Diabetes mellitus | 14 | 16.1 | 15 | 30.0 | 13.9 (−1.0 to 28.8; p = 0.055) | 13.5 (−4.1 to 31.1; p = 0.110) | 14.5 (−14.0 to 43.0; p = 0.320) |
Dyslipidemia | 8 | 9.1 | 8 | 16.0 | 6.9 (− 4.9 to 18.7; p = 0.225) | 3.0 (−8.0 to 14.0; p = 0.569) | 9.0 (−20.7 to 38.7; p = 0.553) |
Cushing’s syndrome Severity Index score* | 6.9 | 2.3 | 6.8 | 2.8 | −0.10 (−0.98 to 0.79; p = 0.832) | 0.09 (−1.00 to 1.17; p = 0.877) | − 0.72 (−2.31 to 0.86; p = 0.357) |
0–4 | 13 | 15.1 | 10 | 20.0 | |||
5–8 | 53 | 61.6 | 27 | 54.0 | |||
9–16 | 20 | 23.2 | 13 | 26.0 | |||
Tumor size | 11.3 (−4.2 to 26.8; p = 0.140) | – | – | ||||
Microadenoma | 69 | 79.3 | 34 | 68.0 | |||
Macroadenoma Cavernous sinus invasion | 185 | 20.7 27.8 | 16 8 | 32.0 50.0 | |||
Referral by other neurosurgeon or university medical center | 4 | 4.6 | 6 | 12.0 | 7.4 (−2.6 to 17.4; p = 0.109) | 3.0 (−5.9 to 11.9; p = 0.459) | 13.9 (−11.8 to 39.6; p = 0.389) |
Medical treatment prior to surgery | 57 | 65.5 | 47 | 94.0 | 28.5 (16.5 to 40.5; p = 0.000) | 34.8 (23.6 to 46.0; p = 0.000) | 14.6 (−14.4 to 43.6; p = 0.335) |
-Metyrapone | 8 | 9.2 | 16 | 32.0 | |||
-Ketoconazole | 51 | 58.6 | 32 | 64.0 | |||
-Pasireotide | 0 | 0.0 | 2 | 4.0 |