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         headline:Radically resected pituitary adenomas: prognostic role of Ki 67 labeling index in a monocentric retrospective series and literature review
         description:Ki-67 Labeling Index is an immunocytochemical marker of cell proliferation. The correlation of Ki-67 expression with pituitary adenomas recurrence has been investigated and is highly debated. Aim of this study was to evaluate whether Ki-67 correlates with recurrence even in patients with an apparently completely removed pituitary adenoma. We retrospectively reviewed the database of the Hypothalamic-Pituitary Disease Unit at the Catholic University of Rome, collected between 2003 and 2011. Inclusion criteria were: patients who underwent surgery at the Department of Neurosurgery with an apparently complete removal of a pituitary adenoma; Ki-67 histological evaluation by the same operator and values of <3 %. All patients underwent endocrine evaluation of the hypothalamic-pituitary function, ophthalmologic and neuro-radiological examinations, during the preoperative period and follow-up. Out of 490 patients recorded on the database of the Hypothalamic-Pituitary Disease Unit at the Catholic University of Rome, 191 cases met the inclusion criteria. Recurrence was observed in 49 cases (25.7 % of the patients who had undergone radical excision). Optional cut-off value was identified at Ki-67 values of 1.50 %. This was associated with worse disease-free survival time, even after correction for age at treatment, gender, positivity to p53, functional classification and Knosp grading. Ki-67 labeling index may be useful in postoperative management, even in patients who underwent radical PA removal. We suggest a Ki-67 cut-off value of 1.5 % to plan an adequate clinical follow-up.
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      headline:Radically resected pituitary adenomas: prognostic role of Ki 67 labeling index in a monocentric retrospective series and literature review
      description:Ki-67 Labeling Index is an immunocytochemical marker of cell proliferation. The correlation of Ki-67 expression with pituitary adenomas recurrence has been investigated and is highly debated. Aim of this study was to evaluate whether Ki-67 correlates with recurrence even in patients with an apparently completely removed pituitary adenoma. We retrospectively reviewed the database of the Hypothalamic-Pituitary Disease Unit at the Catholic University of Rome, collected between 2003 and 2011. Inclusion criteria were: patients who underwent surgery at the Department of Neurosurgery with an apparently complete removal of a pituitary adenoma; Ki-67 histological evaluation by the same operator and values of <3 %. All patients underwent endocrine evaluation of the hypothalamic-pituitary function, ophthalmologic and neuro-radiological examinations, during the preoperative period and follow-up. Out of 490 patients recorded on the database of the Hypothalamic-Pituitary Disease Unit at the Catholic University of Rome, 191 cases met the inclusion criteria. Recurrence was observed in 49 cases (25.7 % of the patients who had undergone radical excision). Optional cut-off value was identified at Ki-67 values of 1.50 %. This was associated with worse disease-free survival time, even after correction for age at treatment, gender, positivity to p53, functional classification and Knosp grading. Ki-67 labeling index may be useful in postoperative management, even in patients who underwent radical PA removal. We suggest a Ki-67 cut-off value of 1.5 % to plan an adequate clinical follow-up.
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            type:Organization
      name:Guido Rindi
      affiliation:
            name:Università Cattolica del Sacro Cuore
            address:
               name:Institute of Anatomic Pathology, Università Cattolica del Sacro Cuore, Rome, Italy
               type:PostalAddress
            type:Organization
      name:Giulio Maira
      affiliation:
            name:Università Cattolica del Sacro Cuore
            address:
               name:Institute of Neurosurgery, Università Cattolica del Sacro Cuore, Rome, Italy
               type:PostalAddress
            type:Organization
      name:Alfredo Pontecorvi
      affiliation:
            name:Università Cattolica del Sacro Cuore
            address:
               name:Section of Endocrinology, Department of Internal Medicine, Università Cattolica del Sacro Cuore, Rome, Italy
               type:PostalAddress
            type:Organization
      name:Laura De Marinis
      affiliation:
            name:Università Cattolica del Sacro Cuore
            address:
               name:Section of Endocrinology, Department of Internal Medicine, Università Cattolica del Sacro Cuore, Rome, Italy
               type:PostalAddress
            type:Organization
PostalAddress:
      name:Section of Endocrinology, Department of Internal Medicine, Università Cattolica del Sacro Cuore, Rome, Italy
      name:Section of Endocrinology, Department of Internal Medicine, Università Cattolica del Sacro Cuore, Rome, Italy
      name:Institute of Neurosurgery, Università Cattolica del Sacro Cuore, Rome, Italy
      name:Institute of Hygiene, Università Cattolica del Sacro Cuore, Rome, Italy
      name:Section of Endocrinology, Department of Internal Medicine, Università Cattolica del Sacro Cuore, Rome, Italy
      name:Section of Endocrinology, Department of Internal Medicine, Università Cattolica del Sacro Cuore, Rome, Italy
      name:Section of Endocrinology, Department of Internal Medicine, Università Cattolica del Sacro Cuore, Rome, Italy
      name:Section of Endocrinology, Department of Internal Medicine, Università Cattolica del Sacro Cuore, Rome, Italy
      name:Institute of Hygiene, Università Cattolica del Sacro Cuore, Rome, Italy
      name:Institute of Neurosurgery, Università Cattolica del Sacro Cuore, Rome, Italy
      name:Institute of Anatomic Pathology, Università Cattolica del Sacro Cuore, Rome, Italy
      name:Institute of Neurosurgery, Università Cattolica del Sacro Cuore, Rome, Italy
      name:Institute of Anatomic Pathology, Università Cattolica del Sacro Cuore, Rome, Italy
      name:Institute of Neurosurgery, Università Cattolica del Sacro Cuore, Rome, Italy
      name:Section of Endocrinology, Department of Internal Medicine, Università Cattolica del Sacro Cuore, Rome, Italy
      name:Section of Endocrinology, Department of Internal Medicine, Università Cattolica del Sacro Cuore, Rome, Italy
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