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However, since prolactinomas are clinically heterogeneous, mortality may not be uniform across data-driven patient profiles.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed 3,378 adult prolactinoma cases (26,118 person-years) from the Surveillance, Epidemiology, and End Results database (2004\u20132022). Standardized mortality ratios (SMRs) were calculated using US life tables matched by age, sex, calendar year, race\/ethnicity, and geography. Among 2,481 patients with available tumor size (18,097 person-years), unsupervised clustering (Fuzzy C-Means) based on age, tumor size, and sex defined patient profiles. Excess mortality ratios (EMRs) compared observed-to-expected mortality across profiles, adjusting for race, calendar year, surgery, and radiotherapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Prolactinoma was associated with significant excess all-cause mortality (SMR 1.21, 95% CI 1.03\u20131.41). Two profiles emerged: SAYF (Small and Young, Female-predominant; 63%) and LOOM (Large or Old, Male-predominant; 37%). Among patients with tumor size data, mortality was increased in LOOM (SMR 1.36, 95% CI 1.11\u20131.65) and reduced in SAYF (SMR 0.48, 95% CI 0.22\u20130.90), with significant between-profile heterogeneity (EMR 2.92, 95% CI 1.44\u20135.90;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003). Results were consistent in sensitivity analyses with imputed data, although the survival advantage in SAYF was attenuated and no longer statistically significant.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Prolactinoma captured in a population-based tumor registry was associated with excess all-cause mortality, with heterogeneity across patient profiles. An older, male-predominant profile with larger tumors showed excess mortality, whereas a younger, female-predominant profile with small tumors showed directionally lower mortality. These hypothesis-generating findings warrant further investigation into the underlying biological and contextual factors.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11102-026-01739-w","type":"journal-article","created":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T19:36:02Z","timestamp":1788464162000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Importance of clinical profiling to determine excess mortality in prolactinomas: insights from a large, registry-based cohort"],"prefix":"10.1007","volume":"29","author":[{"given":"Tarik Ziyad Tarik","family":"Shwaish","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davide","family":"Gori","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudio","family":"Sartori","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federica","family":"Guaraldi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,3]]},"reference":[{"key":"1739_CR1","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1038\/s41574-023-00886-5","volume":"19","author":"S Petersenn","year":"2023","unstructured":"Petersenn S, Fleseriu M, Casanueva FF et al (2023) Diagnosis and management of prolactin-secreting pituitary adenomas: a Pituitary Society international Consensus Statement. 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