The role of surgical management for prolactin-secreting tumors in the era of dopaminergic agonists: An international multicenter report

Findlay, Matthew C.; Sabahi, Mohammadmahdi; Azab, Mohammed; Drexler, Richard; Rotermund, Roman; Ricklefs, Franz L.; Flitsch, Jörg; Smith, Timothy R.; Kilgallon, John L.; Honegger, Jürgen; Nasi-Kordhishti, Isabella; Gardner, Paul A.; Gersey, Zachary C.; Abdallah, Hussein M.; Jane, John A.; Knappe, Ulrich J.; Uksul, Nesrin; Schroder, Henry W.S.; Eördögh, Márton; Losa, Marco; Mortini, Pietro; Gerlach, Rüdiger; Antunes, Apio C.M.; Couldwell, William T.; Budohoski, Karol P.; Rennert, Robert C.; Karsy, Michael

doi:10.1016/j.clineuro.2023.108079

Cited by 4 publications

(1 citation statement)

References 46 publications

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“…The sequelae of sellar mass effect on quality of life [ 8 , 80 , 81 ] is well established, with visual dysfunction [ 82 ], hypopituitarism [ 83 ], and headache [ 84 ] correlated to QOL. Surgery rapidly controls hyperprolactinemia, reduces intrasellar pressure and parasellar mass effect, improves headache [ 85 ], and often facilitates emancipation from DA therapy [ 86 ], leading to substantial and early improvements in QOL. This supports current guidelines recommending surgery as a viable first-line therapy in well-circumscribed prolactinomas without cavernous sinus extension [ 87 ].…”

Section: Discussionmentioning

confidence: 99%

Quality of life in Prolactinoma: A systematic review

Castle-Kirszbaum,

Biermasz,

Kam

et al. 2024

Pituitary

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Background Prolactinomas are common tumours that significantly reduce quality-of-life (QOL) due to sellar mass effect, secondary hypogonadism, and the peripheral effects of prolactin. Understanding the factors that influence QOL would provide insights into therapeutic targets to optimise patient outcomes and improve wellbeing in prolactinoma. Methods A systematic review was performed in accordance with the PRISMA statement. Studies that reported patient QoL using validated metrics were included. Bias and methodological rigour were assessed using the MINORS criteria. Results A total of 18 studies were identified studies were available for review, comprising 877 patients. Most were small cross-sectional studies at high risk of bias. Prolactinoma exhibit worse QOL than healthy controls, particularly mental and psychosocial wellbeing. QOL is also worse than patients with non-functional adenomas, but better than those with Cushing’s disease and acromegaly. QOL correlates with prolactin levels, and approaches population baseline with prolonged biochemical control. Dopamine agonists and surgery both improve overall QOL, however improvements are more rapid with surgery. Conclusion Poor quality of life in prolactinoma is multifactorial, related to biochemical control, side effects of therapy, and sellar mass effect. Targeting persistent symptoms, reducing healthcare costs, and reducing side-effects of therapy are avenues to improving QOL in patients with prolactinoma.

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