CLIPS Grading System Accurately Predicts Cavernous Sinus Invasion in Pituitary Tumors

Retrospective study: CLIPS classification predicts cavernous sinus invasion in pituitary neuroendocrine tumors with sensitivity 90.8%, specificity 98.4%, and better interobserver agreement than Knosp.

• Retrospective analysis of 255 patients (510 cavernous sinuses) undergoing transsphenoidal surgery validated against intraoperative findings and postoperative MRI.
• Interobserver agreement was almost perfect for superior and inferior compartments with CLIPS vs. moderate for Knosp.
• Single-center retrospective design without external validation; previous surgery may reduce accuracy.

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