Purpose: About 30% to 40% of patients with pituitary adenoma require surgery. About 25% to 40% of those who have had surgery will have an aggressive outcome. The purpose of this study was to see if certain clinicopathologic factors such as size, type/subtype, invasiveness, proliferative (ki-67, mitotic rate, and p53), and grade influenced the aggressiveness of postoperative pituitary adenomas. Methods: The factors mentioned in the research objectives were examined as independent variables. Ten studies out of 736 were chosen. The 10 studies had 2727 participants and 632 cases. The monitoring lasted 3-11 years. The studies' quality ranged from fair to excellent. Results: The results of the meta-analysis were: size ≥10mm OR 1,79 (1,29-2,48), corticotroph OR 1,91 (1,41-2,58), invasive OR 3,67 (1,95-6,90), proliferative OR 4,78(3,61-6,32), Ki-67 ≥ 3% OR 4,13 (2,94-5,81), mitotic rate > 2 OR 3,91 (2,74-5,57), p53 positive OR 1,92 (1,28-2,90), and grade 2b OR 4,56 (3,0-6,91). Conclusions: Size, type/subtype, invasiveness, proliferative (ki-67, mitotic rate, and p53), and grade of postoperative pituitary adenoma influenced the postoperative aggressiveness outcome.
