title: Congress of Neurological Surgeons Systematic Review and Evidence-Based Guideline on Posttreatment Follow-up Evaluation of Patients With Nonfunctioning Pituitary Adenomas.
abstract: Nonfunctioning pituitary adenomas (NFPAs) are the most frequent pituitary tumors. Due to the lack of hormonal hypersecretion, posttreatment follow-up evaluation of NFPAs is challenging.
  
  
  
  To create evidence-based guidelines in an attempt to formulate guidance for posttreatment follow-up in a consistent, rigorous, and cost-effective way.
  
  
  
  An extensive literature search was performed. Only clinical articles describing postoperative follow-up of adult patients with NFPAs were included. To ascertain the class of evidence for the posttreatment follow-ups, the authors used the Clinical Assessment evidence-based classification.
  
  
  
  Twenty-three studies met the inclusion criteria with respect to answering the questions on the posttreatment radiologic, endocrinologic, and ophthalmologic follow-up. Through this search, the authors formulated evidence-based guidelines for radiologic, endocrinologic, and ophthalmologic follow-up after surgical and/or radiation treatment.
  
  
  
  Long-term radiologic, endocrinologic, and ophthalmologic surveillance monitoring after surgical and/or radiation therapy treatment of NFPAs to evaluate for tumor recurrence or regrowth, as well as pituitary and visual status, is recommended. There is insufficient evidence to make a recommendation on the duration of time of surveillance and its frequency. It is recommended that the first radiologic study to evaluate the extent of resection of the NFPA be performed ≥3 months after surgical intervention. The full guidelines document for this chapter can be located at https://www.cns.org/guidelines/guidelines-management-patients-non-functioning-pituitary-adenomas/Chapter_8.
  
  
  
  NFPA, nonfunctioning pituitary adenoma.
authors.affiliation: ‡Department of Neurosurgery, Seton Brain and Spine Institute, Austin, Texas; §Department of Neurosurgery, Brigham and Women's Hospital, Boston, Massachusetts; ¶Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California; ‖Departments of Medicine and Neurological Surgery, Oregon Health Science University, Portland, Oregon; #Guidelines Department, Congress of Neurological Surgeons, Schaumburg, Illinois; **Barrow Neurological Institute, Phoenix, Arizona; ‡‡Department of Neurosurgery, Emory University, Atlanta, Georgia; §§Center for Theoretical and Applied Neuro-Oncology, Department of Neuro-Oncology, University of California, San Diego, San Diego, California; ¶¶Department of Neurosurgery, Peking Union Medical College Hospital, Beijing, China; ‖‖Department of Radiology, UC San Diego Health System, University of California, San Diego, San Diego, California; ##Department of Radiology, San Diego Veterans Administration Health System, San Diego, California; ***Department of Neurosurgery, Cedars-Sinai Medical Center, Los Angeles, California; ‡‡‡Department of Neurosurgery, George Washington University, Washington, DC; §§§Department of Neurological Surgery, University of Southern California, Los Angeles, California; ‖‖‖Department of Neurosurgery, University of California, San Francisco, California.
authors.forename: Mateo
authors.initials: M
authors.lastname: Ziu
authors.forename: Ian F
authors.initials: IF
authors.lastname: Dunn
authors.forename: Christopher
authors.initials: C
authors.lastname: Hess
authors.forename: Maria
authors.initials: M
authors.lastname: Fleseriu
authors.forename: Mary E
authors.initials: ME
authors.lastname: Bodach
authors.forename: Luis M
authors.initials: LM
authors.lastname: Tumialan
authors.forename: Nelson M
authors.initials: NM
authors.lastname: Oyesiku
authors.forename: Kunal S
authors.initials: KS
authors.lastname: Patel
authors.forename: Renzhi
authors.initials: R
authors.lastname: Wang
authors.forename: Bob S
authors.initials: BS
authors.lastname: Carter
authors.forename: James Y
authors.initials: JY
authors.lastname: Chen
authors.forename: Clark C
authors.initials: CC
authors.lastname: Chen
authors.forename: Chirag G
authors.initials: CG
authors.lastname: Patil
authors.forename: Zachary
authors.initials: Z
authors.lastname: Litvack
authors.forename: Gabriel
authors.initials: G
authors.lastname: Zada
authors.forename: Manish K
authors.initials: MK
authors.lastname: Aghi
mesh_terms: D000236:Adenoma / Q000628:therapy*; D000328:Adult; D000359:Aftercare / Q000191:economics / Q000379:methods*; D000368:Aged; D003362:Cost-Benefit Analysis; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010911:Pituitary Neoplasms / Q000628:therapy*; D055815:Young Adult