Long-term evolution and outcomes of microprolactinoma with medical treatment

Llanes, María Martín de Santa-Olalla; Melero, Víctor Manuel Andía; Albarrán, Antonino Jara

doi:10.1016/j.endoen.2013.11.006

Cited by 5 publications

(2 citation statements)

References 18 publications

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“…Heterogeneity between groups: p = 0.022 Overall (I 2 = 71.34%, p = 0.00); Cannavò et al [36] Andereggen et al [30] Di Sarno et al [31] Tamasauskas et al [17] Babey et al [16] Vale et al [33] Barber et al [35] Andereggen et al [30] Micko et al [39] Medication Wolfsberger et al [41] Subtotal (I 2 = 74.35%, p = 0.00) Subtotal (I 2 = 7.88%, p = 0.37) Sala et al [34] Torres-García et al [38] Study Yi et al [18] Martin de Santa-Olalla y Llanes et al [32] Kreutzer et al [40] Andereggen et al [ Babey et al [16] Subtotal (I 2 = 77.49%, p = 0.00) Figure 4: Meta-analysis of remission rates comparing surgery and medical treatment in microprolactinomas after treatment withdrawal and the results of subgroup analysis: (a) the remission rate was achieved in 78% of patients treated with surgery and 44% of patients treated with DAs (P � 0.003) after treatment withdrawal and (b) the remission rate was achieved in 92% of patients with preoperative PRL level of ≤200 ng/ml and 40% of patients with preoperative PRL level of >200 ng/ml (P � 0.029).…”

Section: Discussionmentioning

confidence: 99%

Surgery and Medical Treatment in Microprolactinoma: A Systematic Review and Meta-Analysis

Cai

et al. 2021

International Journal of Endocrinology

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Objective. Dopamine agonists (DAs) are recommended as the first-line treatment for prolactinomas; however, tumour recurrence after drug withdrawal remains a clinical problem. Recent studies have reported high remission rates via surgery in microprolactinomas. The aim of this systematic review and meta-analysis was to compare the clinical result of DA treatment with surgery as initial therapy in patients with treatment-naive microprolactinoma. Methods. A comprehensive literature search for studies and reports regarding microprolactinoma patients treated with DAs and/or surgery published between January 1970 and November 2020 was conducted using four electronic databases (PubMed, Embase, Google Scholar, and the Cochrane Library). Clinical treatment outcome was evaluated by the biochemical remission of serum prolactin level to normal after treatment. The I2 statistic was used to quantify heterogeneity. Pooled data were analysed according to a random effect model. Results. Eighteen studies with 661 patients were included for analysis. The DA treatment group achieved a higher remission rate at ≥12 months follow-up (96% vs. 86%; P = 0.019 ). Surgery showed a higher remission rate than the DA treatment group after the treatment withdrawal (78% vs. 44%; P = 0.003 ). Patients with preoperative prolactin level of ≤200 ng/mL had a higher remission rate than patients with preoperative prolactin level of >200 ng/mL (92% vs. 40%; P = 0.029 ). Conclusion. Surgery showed a high remission rate in treatment-naive microprolactinoma patients after treatment withdrawal and may be an alternative first-line treatment strategy in addition to DAs, particularly in patients with a preoperative prolactin level of ≤200 ng/mL.

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Section: Discussionmentioning

confidence: 99%

Surgery and Medical Treatment in Microprolactinoma: A Systematic Review and Meta-Analysis

Cai

et al. 2021

International Journal of Endocrinology

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“…-Clínico. Los prolactinomas producen síntomas asociados al hipogonadismo central provocado por la hiperprolactinemia (oligo-amenorrea, disminución de la libido, disfunción eréctil, infertilidad), por el estímulo sobre glándulas mamarias (galactorrea) o por efecto de masa (cefalea, síndrome quiasmático) 19,31,32 .…”

Section: Diagnósticounclassified

Prolactinoma e hiperprolactinemia. Posicionamiento de la SMNE

Sosa-Eroza¹,

Cuevas‐Ramos²,

Domínguez³

et al. 2024

RME

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Hyperprolactinemia is a very frequent cause for evaluation in daily medical practice, but only some cases with significant and persistent hyperprolactinemia are related to a lactotroph adenoma. We present some recommendations for the diagnostic approach and management of hyperprolactinemia/prolactinoma, emphasizing clinical scenarios were decision may be difficult or in special situations such as pregnancy or pediatric age. This paper does not pretend to be considerate a clinical guideline or a consensus, nonetheless, the Sociedad Mexicana de Nutrición y Endocrinología A.C., and in particular the Neuroendocrinology Task Group, presents this document that shows recent and relevant information that has been analyzed and organized by specialists related to the topic.

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Withdrawal of dopamine agonist therapy in prolactinomas: In which patients and when?

et al. 2016

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The most important predictors of recurrence were maximum tumor diameter and baseline PRL levels in this study. The remission rate in our study group was higher, which was thought to be associated with the longer duration of DA treatment and that our patients were selected according to certain criteria. Despite these positive results, close monitoring is necessary for detection of early and late recurrence, especially within the first year after DA withdrawal.

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Long-term evolution and outcomes of microprolactinoma with medical treatment

Cited by 5 publications

References 18 publications

Surgery and Medical Treatment in Microprolactinoma: A Systematic Review and Meta-Analysis

Surgery and Medical Treatment in Microprolactinoma: A Systematic Review and Meta-Analysis

Prolactinoma e hiperprolactinemia. Posicionamiento de la SMNE

Withdrawal of dopamine agonist therapy in prolactinomas: In which patients and when?

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