Overview
This multicenter cohort study is based on the National Brain Tumor Registry of China (NBTRC). It will compare patients who underwent surgery for Pituitary Neuroendocrine Tumors (PitNETs) detected through health screening versus those diagnosed via outpatient consultations. The study will evaluate differences between the two groups in surgical metrics, patient-centered outcomes, and healthcare utilization.
Description
This multicenter cohort study is based on the National Brain Tumor Registry of China (NBTRC), a nationwide brain tumor registry established by the China National Clinical Research Center for Neurological Diseases.
Patients will be categorized according to their initial consultation department. The screening group will include patients whose tumors were incidentally detected during health screening. The clinical group will include patients diagnosed through outpatient consultations, which will be further subdivided into neurosurgery, ear-nose-throat/ophthalmology, other surgical specialties, and internal medicine. Group assignment will be determined by reviewing each patient's chief complaint, present illness, and past medical history.
The primary outcomes include surgery-related measures (preoperative maximum tumor diameter and extent of resection, defined as gross total resection) and patient-centered outcomes (preoperative symptom phenotype, time from symptom onset to surgery, and postoperative hormonal remission status before discharge). Secondary outcomes reflect socioeconomic burden, including operation duration, length of stay, and total hospitalization costs.
Subgroup analyses will be performed according to functional hormone subtypes. In addition to the two-group comparison between screening and clinical groups, multi-group comparisons will be conducted across different initial consultation departments, with the screening group serving as the reference. Multivariable regression models will be used to adjust for potential confounders, including age, sex, hormone type, insurance status, and hospital-level clustering.
Eligibility
Inclusion Criteria:
- Patients with PitNETs who underwent surgical resection at Beijing Tiantan Hospital from September 1, 2011, to November 30, 2019, together with those recorded in the NBTRC who underwent surgery from December 1, 2019, to December 31, 2021.
Exclusion Criteria:
- The department (health screening or outpatient clinics) where the definitive diagnosis confirmed was missing or unclear
- PitNETs was recurrent or synchronous brain tumors of any histology existed
- Admission was via the emergency department
- Maximum tumor diameter on preoperative MRI were unavailable
- Patients who explicitly declined to participate in this study
