UNASSIGNED: OBJECT Gamma Knife radiosurgery (GKRS) is frequently employed to treat residual or recurrent nonfunctioning @entity4611 . There is no consensus as to whether GKRS should be used early after surgery or if radiosurgery should be withheld until there is evidence of radiographic progression of @entity5 . METHODS This is a retrospective review of @entity1 with nonfunctioning @entity4611 who underwent transsphenoidal surgery followed by GKRS between 1996 and 2013 at the University of Virginia Health System. @entity1 were stratified based on the interval between resection and radiosurgery. Operative results and imaging and clinical outcomes were compared across groups following early ( <= 6 months) or late (> 6 months) radiosurgery. RESULTS Sixty-four @entity1 met the study criteria and were grouped based on early (n = 32) or late (n = 32) GKRS following transsphenoidal resection. There was a greater risk of @entity5 progression after GKRS in the late radiosurgical group (p = 0.027) over a median radiographic follow-up period of 68.5 months. Furthermore, there was a significantly higher occurrence of @entity508 in the late radiosurgical cohort (p = 0.041). Seventeen percent of @entity1 without @entity2744 in the early cohort developed new @entity2744 during the follow-up period versus 64% in the late cohort (p = 0.036). This difference was primarily due to a significantly higher rate of @entity5 growth during the observation period of the late treatment cohort (p = 0.014). Of these @entity1 with completely new @entity2744 , radiation-associated @entity4614 developed in 1 of 2 @entity1 in the early group and in 3 of 7 (42.9%) @entity1 in the late group. CONCLUSIONS Early treatment with GKRS appears to decrease the rate of radiographic and symptomatic progression of subtotally resected nonfunctioning @entity4611 compared with late GKRS treatment after a period of expectant management. Delaying radiosurgery may place the @entity1 at increased risk for @entity652 and @entity2744 .

Early versus late Gamma Knife radiosurgery following transsphenoidal resection for nonfunctioning XXXX : a matched cohort study.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'patient'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumor'] @entity508 :: ('MESH:D009128', 'Disease') :: ['post-GKRS endocrinopathy'] @entity4611 :: ('MESH:D010900', 'Disease') :: ['pituitary macroadenomas'] @entity4614 :: ('MESH:D007018', 'Disease') :: ['pituitary insufficiency'] @entity2744 :: ('MESH:C567425', 'Disease') :: ['endocrinopathies', 'endocrinopathy'] @entity652 :: ('MESH:D000236', 'Disease') :: ['adenoma progression']
@entity4611 :: (MESH:D010900,Disease) :: ['pituitary macroadenomas']
