title: Association of pituitary stalk management with endocrine outcomes and recurrence in microsurgery of craniopharyngiomas: A meta-analysis.
abstract: OBJECTIVE
  A craniopharyngioma (CP) is a benign tumor commonly considered to originate from the pituitary stalk. However, it is still controversial as to whether the pituitary stalk should be maintained after microsurgery to resect the tumor despite its own physiological function of the pituitary stalk. In this study, meta-analysis was conducted to evaluate the influence of the pituitary stalk resection on endocrine function and tumor recurrence rate.
  
  
  METHODS
  The relevant publications were identified by searching databases including Pubmed, Embase, Medline, and Web of Science. The extracted data were used as the basis for the meta-analysis by the RevMan 5.2 software program.
  
  
  RESULTS
  Seven articles were selected, including 420 clinical cases. The meta-analysis showed that retaining the pituitary stalk might reduce the occurrence rate of diabetes insipidus (OR=0.21, 95%CI=0.10, 0.46, P=0.0001) and the risk of potential impairment of anterior pituitary function (OR=0.04, 95%CI=0.01, 0.13, P<0.0001). However, there was no significant relationship between craniopharyngioma recurrence and pituitary stalk treatment (i.e., preservation or resection) (OR=1.40, 95%CI=0.59, 3.34, P=0.45).
  
  
  CONCLUSIONS
  The maintenance of the pituitary stalk may reduce the alterations in endocrine function and the occurrence of diabetes insipidus. However, it is not likely to enhance the recurrence rate of craniopharyngiomas.
authors.affiliation: Department of Neurosurgery, First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing 210029, Jiangsu, People's Republic of China; Department of Neurosurgery, Second Affiliated Hospital of Nanjing Medical University, 121 Jiangjiayuan Road, Nanjing 210011, Jiangsu, People's Republic of China.
authors.forename: Kai
authors.initials: K
authors.lastname: Li
authors.affiliation: Department of Neurosurgery, First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing 210029, Jiangsu, People's Republic of China.
authors.forename: Xiaocheng
authors.initials: X
authors.lastname: Lu
authors.affiliation: Department of Pharmaceutical Sciences, Manchester University College of Pharmacy, 10627 Diebold Road, Fort Wayne 46845, USA.
authors.forename: Ningning
authors.initials: N
authors.lastname: Yang
authors.affiliation: Department of Neurosurgery, First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing 210029, Jiangsu, People's Republic of China.
authors.forename: Jinyu
authors.initials: J
authors.lastname: Zheng
authors.affiliation: Department of Neurosurgery, First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing 210029, Jiangsu, People's Republic of China.
authors.forename: Baosheng
authors.initials: B
authors.lastname: Huang
authors.affiliation: Department of Neurosurgery, First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing 210029, Jiangsu, People's Republic of China. Electronic address: lilixin2@hotmail.com.
authors.forename: Lixin
authors.initials: L
authors.lastname: Li
mesh_terms: D003397:Craniopharyngioma / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D008866:Microsurgery; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000601:surgery*; D019635:Neurosurgical Procedures / Q000379:methods; D010902:Pituitary Gland / Q000503:physiopathology / Q000601:surgery*; D010911:Pituitary Neoplasms / Q000601:surgery*; D012189:Retrospective Studies
keywords: Craniopharyngioma; Endocrine function; Meta-analysis; Microsurgery; Pituitary stalk; Recurrence