Geographic and Socioeconomic Predictors of Early Follow-Up Loss in Patients Undergoing Pituitary Neuroendocrine Tumors (PitNETs) Resection: A retrospective review of 1143 cases

Authors

Daniel Quintana, University of California San Francisco, San Francisco, CA
Rithvik Ramesh, University of California San Francisco, San Francisco, CA
Robert C. Osorio, University of California San Francisco, San Francisco, CA
Wesley Shoap, LSU Health Sciences Center – New OrleansFollow
Paul McMillan Villalobos, University of California San Francisco, San Francisco, CA
Philip V. Theodosopoulos, University of California San Francisco, San Francisco, CA
Sandeep Kunwar, University of California San Francisco, San Francisco, CA
Jose Gurrola, University of California San Francisco, San Francisco, CA
Ivan H. El Sayed, University of California San Francisco, San Francisco, CA
Manish K. Aghi, University of California San Francisco, San Francisco, CA
Ezequiel Goldschmidt, University of California San Francisco, San Francisco, CA

Document Type

Article

Publication Date

11-24-2025

Publication Title

World Neurosurgery

Abstract

OBJECTIVE: Postoperative follow-up after PitNET resection is essential for monitoring tumor recurrence and endocrinological deficits. Despite advances in telehealth, loss to follow-up remains a persistent challenge across neurosurgical patients. This study aims to identify factors to identify patients are at higher risk of being lost to follow-up after surgery. METHODS: A retrospective analysis was conducted on 1,143 adult patients who underwent PitNET resection between 2012 and 2019 at a single institution. Clinical and radiological data were analyzed to assess loss to follow-up in the cohort. Multivariable logistic and negative binomial regression models were used to identify factors independently associated with follow-up loss. RESULTS: Of the 1,143 patients included, 131 (11.5%) were lost to follow-up within 3 months after surgery. Compared to those with longer follow-up, these patients were younger (median 44.0 vs. 51.0 years, p = 0.032), lived farther from the medical center (515.5 vs. 309.7 km, p = 0.024), experienced longer delays to surgery (148 vs. 104 days, p = 0.027), and had smaller tumors (1.54 vs. 1.74 cm, p = 0.04). Multivariable analysis identified uninsured status (OR 3.43, 95% CI 1.14-10.33, p = 0.02) and greater distance to care (OR 1.01, 95% CI 1.00-1.01, p = 0.03) as independent predictors of early follow-up loss. CONCLUSION: To follow-up after PitNET surgery remains a substantial concern, particularly among younger, uninsured patients and those residing farther from the treating center. These findings highlight the importance of early identification and proactive outreach to high-risk individuals.

First Page

124643

PubMed ID

41297625

Volume

205

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.

Recommended Citation

Quintana, Daniel; Ramesh, Rithvik; Osorio, Robert C.; Shoap, Wesley; McMillan Villalobos, Paul; Theodosopoulos, Philip V.; Kunwar, Sandeep; Gurrola, Jose; El Sayed, Ivan H.; Aghi, Manish K.; and Goldschmidt, Ezequiel, "Geographic and Socioeconomic Predictors of Early Follow-Up Loss in Patients Undergoing Pituitary Neuroendocrine Tumors (PitNETs) Resection: A retrospective review of 1143 cases" (2025). School of Medicine Faculty Publications. 4383.
https://digitalscholar.lsuhsc.edu/som_facpubs/4383
10.1016/j.wneu.2025.124643