Long-term Outcome of Microscopic Transsphenoidal Surgery for Prolactinomas as an Alternative to Dopamine Agonists
- Author:
Kawngwoo PARK
1
;
Kwang Hyon PARK
;
Hye Ran PARK
;
Jae Meen LEE
;
Yong Hwy KIM
;
Dong-Young KIM
;
Tae-Bin WON
;
Sung Hye KONG
;
Jung Hee KIM
;
Chan Soo SHIN
;
Sun Ha PAEK
Author Information
- Publication Type:Original Article
- From:Journal of Korean Medical Science 2021;36(15):e97-
- CountryRepublic of Korea
- Language:English
-
Abstract:
Background:Although long-term dopamine agonist (DA) therapy is recommended as a first-line treatment for prolactinoma, some patients may prefer surgical treatment because of the potential adverse effects of long-term medication, or the desire to become pregnant. This study aimed to determine whether surgical treatment of prolactinomas could be an alternative to DA therapy.
Methods:In this retrospective study, 96 consecutive patients (74 female, 22 male) underwent primary pituitary surgery without long-term DA treatment for prolactinomas at a single institution from 1990 to 2010. All patients underwent primary surgical treatment in the microscopic transsphenoidal approach (TSA).
Results:The median age and median follow-up period were 31 (16–73) years and 139.1 (12.2–319.6) months, respectively. An initial overall remission was accomplished in 47.9% (46 of 96 patients, 33 macroadenomas, and 13 microadenomas) of patients. DA dose reduction was achieved in all patients after TSA. A better remission rate was independently predicted by lower diagnostic prolactin levels and by a greater extent of surgical resection. Overall remission at the last follow-up was 33.3%, and the overall recurrence rate was 30.4%. The permanent complication rate was 3.1%, and there was no mortality.
Conclusion:TSA can be considered a safe and potentially curative treatment for selective microprolactinomas as an alternative to treatment with a long-term DA.
