Cochrane · systematic review · CD013561
Surgical and non‐surgical interventions for primary and salvage treatment of growth hormone‐secreting pituitary adenomas in adults
Caulley, L, Quinn, JG, Doyle, M-A, et al. · Cochrane Database of Systematic Reviews · 2024 · Cochrane Library
Metabolic and Endocrine DisordersAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
14
current version
GRADE rated
6
No studies
7
Included studies
NR
No studies 7 · 50%Ungraded 1 · 7.1%Very low 5 · 35.7%Low 1 · 7.1%Moderate 0 · 0%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Surgery alone compared with pharmacological therapy alone
Population: adults with growth‐hormone secreting pituitary adenomas
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Disease‐related complications Surgery alone vs pharmacological therapy alone | no estimate extracted | NR | No studies |
Disease recurrence Surgery alone vs pharmacological therapy alone | no estimate extracted | NR | No studies |
Adverse events Surgery alone vs pharmacological therapy alone | RR 0.09 [0.01, 1.47] | 1 study · 22 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
All‐cause mortality Surgery alone vs pharmacological therapy alone | no estimate extracted | NR | No studies |
Surgery for recurrent or persistent disease Surgery alone vs pharmacological therapy alone | no estimate extracted | NR | No studies |
Non‐surgical therapy for recurrent or persistent disease Surgery alone vs pharmacological therapy alone | no estimate extracted | NR | No studies |
Health‐related quality of life Mean AcroQoL score (0‐100) Surgery alone vs pharmacological therapy alone | MD 10 | 1 study · 22 participants | Low Downgraded: risk of bias, imprecision |
Surgery alone compared with preoperative pharmacological therapy and surgery for growth‐hormone secreting pituitary adenomas
Population: adults with growth‐hormone secreting pituitary adenomas
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Disease‐related complications Intubation difficulties requiring postponement of surgery Surgery alone vs preoperative pharmacological therapy and surgery | RR 2 [0.19, 21.34] | 1 study · 98 participants | Very low Downgraded: risk of bias, imprecision |
Disease recurrence Surgery alone vs preoperative pharmacological therapy and surgery | no estimate extracted | 1 study · 61 participants | Ungraded |
Adverse events Surgery alone vs preoperative pharmacological therapy and surgery | RR 1.23 [0.7, 2.03] | 5 studies · 267 participants | Very low Downgraded: risk of bias, imprecision, inconsistency |
All‐cause mortality Surgery alone vs preoperative pharmacological therapy and surgery | no estimate extracted | NR | No studies |
Surgery for recurrent or persistent disease Surgery alone vs preoperative pharmacological therapy and surgery | RR 0.48 [0.05, 5.06] | 1 study · 61 participants | Very low Downgraded: risk of bias, imprecision |
Non‐surgical therapy for recurrent or persistent diseaseRadiation therapy and/or pharmacologic therapy for recurrent or persistent disease Surgery alone vs preoperative pharmacological therapy and surgery | RR 1.22 [0.65, 2.28] | 2 studies · 100 participants | Very low Downgraded: risk of bias, imprecision |
Health‐related quality of life Surgery alone vs preoperative pharmacological therapy and surgery | no estimate extracted | NR | No studies |