The Combination of Dopamine Agonist Treatment and Surgery May Be the Best Option in Challenging Prolactinoma Cases: A Single-Centre Experience

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dc.authoridDemir, Ahmet Numan/0000-0002-9997-7051
dc.authoridKadioglu, Pinar/0000-0002-8329-140X
dc.authoridÇetintaş, Semih Can/0000-0001-6036-164X
dc.authoridGazioglu, Nurperi/0000-0001-7785-8628
dc.authoridZULFALIYEVA, GULDANA/0000-0001-6675-0160
dc.authoridSulu, Cem/0000-0003-2493-6068
dc.authoridOzaydin, Dilan/0000-0002-1525-7613
dc.authorwosidDemir, Ahmet Numan/AEK-2338-2022
dc.authorwosidKadioglu, Pinar/AAM-9935-2020
dc.authorwosidÇetintaş, Semih Can/AAA-3044-2020
dc.authorwosidÖzaydın, DİLAN/HTO-4325-2023
dc.contributor.authorDemir, Dilan
dc.contributor.authorDemir, Ahmet Numan
dc.contributor.authorSulu, Cem
dc.contributor.authorZulfaliyeva, Guldana
dc.contributor.authorCetintas, Semih Can
dc.contributor.authorOzkaya, Hande Mefkure
dc.contributor.authorKadioglu, Pinar
dc.date.accessioned2024-05-19T14:41:16Z
dc.date.available2024-05-19T14:41:16Z
dc.date.issued2023
dc.departmentİstinye Üniversitesien_US
dc.description.abstract-OBJECTIVE: To investigate the initial and long-term remission rates, factors related to remission, secondary treatments, and outcomes for patients with prolactinoma who underwent endoscopic transsphenoidal surgery (ETSS).-METHODS: The medical files of the 45 prolactinoma patients who underwent ETSS between 2015 and 2022 were retrospectively reviewed. Relevant demographic and clin-ical data were obtained. -RESULTS: Twenty-one (46.7%) patients were female. The median age of patients at ETSS was 35 (interquartile range, 22.5-50) years. The median clinical follow-up of patients was 28 (interquartile range 12-44) months. The initial surgical remission rate was 60%. Recurrence was detected in 7 patients (25.9%). Postoperative dopamine agonists were used in 25 patients, radiosurgery in 2, and second ETSS in 4 patients. After these secondary treatments, the long-term biochemical remission rate was 91.1%. The factors associated with failure in surgical remission are: male gender, older age, higher tumor size, advanced Knosp and Hardy stage, and elevated prolactin level at diagnosis. A prolactin level of <19 ng/mL in the first postoperative week predicted surgical remission with a sensitivity of 77.8% and a specificity of 70.6% in patients who received preoperative dopamine agonist treatment. -CONCLUSIONS: In macro adenomas and/or giant ade-nomas with cavernous sinus invasion, and significant suprasellar extension, which constitutes the difficult part of prolactinoma treatment, neither surgery nor medical treatment alone may be effective enough. Both treatment modalities should be carried out together by a team of neurosurgery and endocrinology in the management of these patients.en_US
dc.identifier.doi10.1016/j.wneu.2023.04.089
dc.identifier.endpageE1174en_US
dc.identifier.issn1878-8750
dc.identifier.issn1878-8769
dc.identifier.pmid37120141en_US
dc.identifier.scopus2-s2.0-85159913772en_US
dc.identifier.scopusqualityQ2en_US
dc.identifier.startpageE1166en_US
dc.identifier.urihttps://doi.org10.1016/j.wneu.2023.04.089
dc.identifier.urihttps://hdl.handle.net/20.500.12713/5085
dc.identifier.volume175en_US
dc.identifier.wosWOS:001028793300001en_US
dc.identifier.wosqualityN/Aen_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.language.isoenen_US
dc.publisherElsevier Science Incen_US
dc.relation.ispartofWorld Neurosurgeryen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.snmz20240519_kaen_US
dc.subjectEndoscopic Endonasalen_US
dc.subjectProlactinomaen_US
dc.subjectRemissionen_US
dc.subjectTranssphenoidal Surgeryen_US
dc.titleThe Combination of Dopamine Agonist Treatment and Surgery May Be the Best Option in Challenging Prolactinoma Cases: A Single-Centre Experienceen_US
dc.typeArticleen_US

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