Abstract
Background
Endoscopic endonasal surgery (EES) is the primary approach for pituitary neuroendocrine tumors (PitNET); however, outcome reporting remains heterogeneous and inconsistent, limiting reproducibility, comparability, and evidence synthesis. We aimed to assess the reporting quality in EES-for-PitNET studies and develop a dedicated Reporting guideline.Methods
PubMed, Embase, Scopus, and Web of Science were systematically searched from inception to January 27, 2026. Original clinical studies (≥10 patients) reporting clinical, surgical, endocrinological, radiological, perioperative, or follow-up outcomes after endoscopic endonasal/transsphenoidal/transnasal surgery for PitNET were included. The reporting quality was assessed across nine domains: baseline characteristics, imaging and tumor features, definitions of key concepts, team characteristics, anesthetic protocol, surgical details, outcomes and adverse events, retreatment, and funding/conflicts of interest.Results
Thirty study-records comprising approximately 15,800 patients were included. Reporting deficiencies were identified across all domains. Age (93%) and sex (100%) were almost universally reported and the treatment modality was always defined (100%); however, comorbidities were fully detailed in only 10%, and a comprehensive anesthetic protocol was essentially absent (3%). Key terms were defined in 53%, intraoperative adverse-event classification in 17%, and all-cause and procedure-related mortality criteria in 0%. Surgeon's experience was reported in 63%, time from symptom onset to treatment in 3%, and retreatment frequency and indications in 17% and 27%, respectively. Based on these gaps we developed the Endoscopic Endonasal Pituitary Neuroendocrine Tumor Reporting Guideline.Conclusion
EES-for-PitNET literature demonstrates substantial reporting deficiencies that limit evidence reliability and synthesis. The proposed Reporting Guideline provides a structured framework to improve transparency, reproducibility, and comparability in future studies.