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.
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.
Study Type
OBSERVATIONAL
Enrollment
5,000
the National Brain Tumor Registry of China (NBTRC)
Beijing, Beijing Municipality, China
RECRUITINGPreoperative maximum tumor diameter
Maximum tumor diameter in millimeters, measured on preoperative Magnetic Resonance Imaging (MRI), defined as the largest dimension of the tumor.
Time frame: Within 3 months before surgery
Extent of resection
Gross total resection (GTR) versus non-GTR, assessed by intraoperative findings combined with MRI performed within 72 hours after surgery.
Time frame: Within 72 hours after surgery
Preoperative symptom phenotype
Presence or absence of preoperative symptoms (including visual decline, headache, hyperpituitarism, hypopituitarism, diplopia, cerebrospinal fluid leak, nonspecific symptoms, and other symptoms) reported by the patient at hospital admission, reflecting symptoms experienced during the preoperative period.
Time frame: At hospital admission
Time interval from symptom onset to surgery
Time in months from the date of symptom onset to the date of surgery, calculated from patient-reported history documented in medical records.
Time frame: At hospital admission
Postoperative hormone remission status
Biochemical remission of functioning adenomas (Prolactin \[PRL\], Growth Hormone \[GH\], Adrenocorticotropic Hormone \[ACTH\], Thyroid-Stimulating Hormone \[TSH\]) assessed before hospital discharge, based on disease-specific criteria per Endocrine Society guidelines.
Time frame: At hospital discharge
Length of hospital stay
Number of days from admission to discharge, calculated from medical records.
Time frame: At hospital discharge
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Operation duration
Total time of surgery, measured from the start to the end of the procedure, extracted from surgical records.
Time frame: At the end of surgery
Total hospitalization costs
Total inpatient expenses in Chinese Yuan (CNY) during the index admission, including all medical services, medications, imaging, laboratory tests, and surgical fees, extracted from hospital billing records.
Time frame: At hospital discharge