{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T12:29:12Z","timestamp":1763468952293,"version":"3.37.3"},"reference-count":46,"publisher":"Georg Thieme Verlag KG","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Exp Clin Endocrinol Diabetes"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:p>Abstract<\/jats:p><jats:p>\n          Background Current guidelines recommend dopamine agonists (DA) as the\n                    primary therapeutic approach for prolactinomas; however, emerging evidence\n                    suggests that surgical intervention can also yield favorable outcomes.<\/jats:p><jats:p>\n          Objective To comprehensively evaluate prolactinoma patients undergoing\n                    surgical and medical treatments at our pituitary center.<\/jats:p><jats:p>\n          Methods Retrospective review of mMedical records from prolactinoma\n                    patients treated between 2015 and 2022 was performedwere retrospectively\n                    reviewed. The study focused on treatment outcomes and remission rates while\n                    investigating factors influencing the success of both treatment modalities in\n                    achieving remission.<\/jats:p><jats:p>\n          Results A total of 301 prolactinoma patients were included, of whom 199\n                    were women. Among them, 235 were managed medically, while 66 underwent surgical\n                    intervention. The overall remission rates of patients treated with medical and\n                    surgery were similar at the final examination (Respectively respectively 82.9%\n                    and 81.8%, p=0.114). Factors associated with remission in both treatment\n                    modalities included female sex, low initial prolactin levels, small adenoma\n                    size, and absence of cavernous invasion. Compared to DA treatment, Ssurgical\n                    treatment demonstrated a higher rate of drug-free remission compared to DA\n                    treatment for microadenomas, and macroadenomas without cavernous invasion. In\n                    cases with cavernous invasion, standalone surgical treatment yielded a low rate\n                    of drug-free remission (7.7%); however, when combined with DA therapy\n                    post-surgery, remission rates increased to 66.7%.<\/jats:p><jats:p>\n          Conclusion Medical treatment with DAs remains the preferred option for\n                    macroadenomas with cavernous sinus invasion, and giant adenomas, with surgery\n                    reserved for selected cases to address complications. Conversely, surgery\n                    emerges as the most effective modality for achieving remission in patients with\n                    microadenomas, and macroadenomas confined to the sella. The recommendation of\n                    DAs as first-line therapy for all patients has been withdrawn in the current\n                    guidelines, and individual treatment approaches based on tumor characteristics\n                    are emphasized. Our results support this approach.<\/jats:p>","DOI":"10.1055\/a-2364-6027","type":"journal-article","created":{"date-parts":[[2024,7,11]],"date-time":"2024-07-11T22:59:18Z","timestamp":1720738758000},"page":"570-580","source":"Crossref","is-referenced-by-count":2,"title":["Role of Medical and Surgical Treatment in Management of the Patients\n                    With Prolactinoma: A Single-Center Experience"],"prefix":"10.1055","volume":"132","author":[{"given":"Guldana","family":"Zulfaliyeva","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Istanbul\n                    University-Cerrahpasa, Istanbul, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmet Numan","family":"Demir","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Metabolism and Diabetes,\n                    Istanbul University-Cerrahpasa, Istanbul, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Semih Can","family":"Cetintas","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Istanbul\n                    University-Cerrahpasa, Istanbul, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dilan","family":"Ozaydin","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Health Science University Kartal Dr Lutfi\n                    K\u0131rdar City Hospital, Istanbul, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Necmettin","family":"Tanriover","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Istanbul\n                    University-Cerrahpasa, Istanbul, Turkey"},{"name":"Pituitary Center, Istanbul University-Cerrahpasa, Istanbul,\n                    Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8329-140X","authenticated-orcid":false,"given":"Pinar","family":"Kadioglu","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Metabolism and Diabetes,\n                    Istanbul University-Cerrahpasa, Istanbul, Turkey"},{"name":"Pituitary Center, Istanbul University-Cerrahpasa, Istanbul,\n                    Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2024,8,30]]},"reference":[{"key":"ref1","first-page":"66","article-title":"The discovery of human prolactin: A very personal account","volume":"18","author":"H G Friesen","year":"1995","journal-title":"Clin Invest Med"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1083","DOI":"10.3171\/jns.2001.95.6.1083","article-title":"The history and evolution of transsphenoidal surgery","volume":"95","author":"J K Liu","year":"2001","journal-title":"J Neurosurg"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"295","DOI":"10.1210\/edrv-1-3-295","article-title":"Prolactin-secreting pituitary tumors in amenorrheic women: A comprehensive\n                    study","volume":"1","author":"J Schlechte","year":"1980","journal-title":"Endocr Rev"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"325","DOI":"10.1016\/0018-506x(81)90001-5","article-title":"Historical origins of modern research on hormones and behavior","volume":"15","author":"F A Beach","year":"1981","journal-title":"Horm Behav"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1523","DOI":"10.1152\/physrev.2000.80.4.1523","article-title":"Prolactin: Structure, function, and regulation of secretion","volume":"80","author":"M E Freeman","year":"2000","journal-title":"Physiol Rev"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"220","DOI":"10.1210\/edrv-13-2-220","article-title":"Dopamine agonists and pituitary tumor shrinkage","volume":"13","author":"J S Bevan","year":"1992","journal-title":"Endocr Rev"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"273","DOI":"10.1210\/jc.2010-1692","article-title":"Diagnosis and treatment of hyperprolactinemia: An Endocrine Society clinical\n                    practice guideline","volume":"96","author":"S Melmed","year":"2011","journal-title":"J Clin Endocrinol Metab"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"947","DOI":"10.1210\/endrev\/bnad014","article-title":"Current and future advances in surgical therapy for pituitary adenoma","volume":"44","author":"D Z Khan","year":"2023","journal-title":"Endocr Rev"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"2621","DOI":"10.1007\/s40618-021-01569-6","article-title":"First-line surgery in prolactinomas: Lessons from a long-term follow-up study in\n                    a tertiary referral center","volume":"44","author":"L Andereggen","year":"2021","journal-title":"J Endocrinol Invest"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1007\/s11102-019-01016-z","article-title":"Surgery for prolactinomas: A better choice?","volume":"23","author":"J Honegger","year":"2020","journal-title":"Pituitary"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1159\/000309679","article-title":"The normal visual field on the Humphrey field analyzer","volume":"193","author":"R S Brenton","year":"1986","journal-title":"Ophthalmologica"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1017\/s0317167100030055","article-title":"Surgical management of giant pituitary adenomas","volume":"17","author":"G Mohr","year":"1990","journal-title":"Can J Neurol Sci"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"610","DOI":"10.1227\/00006123-199310000-00008","article-title":"Pituitary adenomas with invasion of the cavernous sinus space: A magnetic\n                    resonance imaging classification compared with surgical findings","volume":"33","author":"E Knosp","year":"1993","journal-title":"Neurosurgery"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1007\/s11102-019-01009-y","article-title":"Prolactinomas in males: Any differences?","volume":"23","author":"H Duskin-Bitan","year":"2020","journal-title":"Pituitary"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"1338345","DOI":"10.3389\/fendo.2024.1338345","article-title":"Prolactin-secreting pituitary adenomas: Male-specific differences in\n                    pathogenesis, clinical presentation and treatment","volume":"15","author":"L Dzialach","year":"2024","journal-title":"Front Endocrinol (Lausanne)"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"1135","DOI":"10.18621\/eurj.1340508","article-title":"Evaluation of the gender effect in operated prolactinomas","volume":"9","author":"D Ozaydin","year":"2023","journal-title":"Eur Res J"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"2102","DOI":"10.1210\/jcem.82.7.4088","article-title":"Sex-related difference in the growth of prolactinomas: A clinical and\n                    proliferation marker study","volume":"82","author":"E Delgrange","year":"1997","journal-title":"J Clin Endocrinol Metab"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"386","DOI":"10.1016\/s0090-3019(03)00012-0","article-title":"Growth potential of prolactinomas in men: Is it really different from\n                    women?","volume":"59","author":"H Nishioka","year":"2003","journal-title":"Surg Neurol"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"114","DOI":"10.1016\/j.urology.2021.03.007","article-title":"Prevalence of hyperprolactinemia and clinically apparent prolactinomas in men\n                    undergoing fertility evaluation","volume":"159","author":"S S Ambulkar","year":"2022","journal-title":"Urology"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"325","DOI":"10.1530\/eje.0.1480325","article-title":"Gender differences in the prevalence, clinical features and response to\n                    cabergoline in hyperprolactinemia","volume":"148","author":"A Colao","year":"2003","journal-title":"Eur J Endocrinol"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1007\/s11102-007-0065-3","article-title":"Aromatase cytochrome P450 enzyme expression in human pituitary","volume":"11","author":"P Kadioglu","year":"2008","journal-title":"Pituitary"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"386","DOI":"10.1007\/s11102-012-0436-2","article-title":"Aromatase cytochrome P450 enzyme expression in prolactinomas and its\n                    relationship to tumor behavior","volume":"16","author":"H Akinci","year":"2013","journal-title":"Pituitary"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"1046","DOI":"10.4065\/73.11.1046","article-title":"Prolactinomas in male and female patients: A comparative clinicopathologic\n                    study","volume":"73","author":"R D Calle-Rodrigue","year":"1998","journal-title":"Mayo Clin Proc"},{"key":"ref24","first-page":"152","article-title":"Gender-related differences in prolactinomas. A clinicopathological study\n                    [published correction in Neuro Endocrinol Lett 2005; 26: 628]","volume":"26","author":"B Schaller","year":"2005","journal-title":"Neuro Endocrinol Lett"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1159\/000318494","article-title":"Gender differences in macroprolactinomas: Study of clinical features, outcome of\n                    patients and ki-67 expression in tumor tissue","volume":"38","author":"P Fainstein Day","year":"2010","journal-title":"Front Horm Res"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"751","DOI":"10.1007\/s00701-005-0498-2","article-title":"Clinical and histological correlations in prolactinomas, with special reference\n                    to bromocriptine resistance","volume":"147","author":"E Delgrange","year":"2005","journal-title":"Acta Neurochir (Wien)"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"2400","DOI":"10.1210\/clinem\/dgad174","article-title":"Approach to the patient with prolactinoma","volume":"108","author":"R S Auriemma","year":"2023","journal-title":"J Clin Endocrinol Metab"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"101290","DOI":"10.1016\/j.beem.2019.101290","article-title":"The epidemiology, diagnosis and treatment of prolactinomas: The old and the\n                    new","volume":"33","author":"P Chanson","year":"2019","journal-title":"Best Pract Res Clin Endocrinol Metab"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"R89","DOI":"10.1530\/EJE-16-0087","article-title":"Therapy of endocrine disease: Surgery in microprolactinomas: Eeffectiveness and\n                    risks based on contemporary literature","volume":"175","author":"M Tampourlou","year":"2016","journal-title":"Eur J Endocrinol"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"3180","DOI":"10.1210\/jcem.87.7.8645","article-title":"Surgical treatment of prolactin-secreting pituitary adenomas: Early results and\n                    long-term outcome","volume":"87","author":"M Losa","year":"2002","journal-title":"J Clin Endocrinol Metab"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"935","DOI":"10.1007\/s00701-003-0134-y","article-title":"Microprolactinomas in males treated by transsphenoidal surgery","volume":"145","author":"S Wolfsberger","year":"2003","journal-title":"Acta Neurochir (Wien)"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"e32","DOI":"10.1210\/clinem\/dgz144","article-title":"Surgery as a viable alternative first-line treatment for prolactinoma patients.\n                    A systematic review and meta-analysis","volume":"105","author":"A H Zamanipoor Najafabadi","year":"2020","journal-title":"J Clin Endocrinol Metab"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"489","DOI":"10.1007\/s11102-017-0838-2","article-title":"Criteria for the definition of Pituitary Tumor Centers of Excellence (PTCOE): A\n                    Pituitary Society Statement [published correction in Pituitary 2018 20]","volume":"20","author":"F F Casanueva","year":"2017","journal-title":"Pituitary"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"P1","DOI":"10.1530\/EJE-21-0977","article-title":"Italian Association of Clinical Endocrinologists (AME) and International Chapter\n                    of Clinical Endocrinology (ICCE). Position statement for clinical practice:\n                    Prolactin-secreting tumors","volume":"186","author":"R Cozzi","year":"2022","journal-title":"Eur J Endocrinol"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"1","DOI":"10.33393\/grhta.2024.2601","article-title":"A pharmacoeconomic analysis from Italian guidelines for the management of\n                    prolactinomas","volume":"11","author":"M Basile","year":"2024","journal-title":"Glob Reg Health Technol Assess"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"722","DOI":"10.1038\/s41574-023-00886-5","article-title":"Diagnosis and management of prolactin-secreting pituitary adenomas: A Pituitary\n                    Society International Consensus Statement","volume":"19","author":"S Petersenn","year":"2023","journal-title":"[published correction in Nat Rev Endocrinol 2023]. Nat Rev\n                    Endocrinol"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"102919","DOI":"10.1016\/j.arcmed.2023.102919","article-title":"Efficacy and safety of endoscopic transsphenoidal resection for prolactinoma: A\n                    retrospective multicenter case-series","volume":"54","author":"I M Zandbergen","year":"2023","journal-title":"Arch Med Res"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"e1166","DOI":"10.1016\/j.wneu.2023.04.089","article-title":"The combination of dopamine agonist treatment and surgery may be the best option\n                    in challenging prolactinoma cases: A single-centre experience","volume":"175","author":"D Demir","year":"2023","journal-title":"World Neurosurg"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1530\/EJE-07-0248","article-title":"Operative treatment of prolactinomas: Indications and results in a current\n                    consecutive series of 212 patients","volume":"158","author":"J Kreutzer","year":"2008","journal-title":"Eur J Endocrinol"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1017\/s0317167100030055","article-title":"Surgical management of giant pituitary adenomas","volume":"17","author":"G Mohr","year":"1990","journal-title":"Can J Neurol Sci"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"621","DOI":"10.3171\/2012.11.JNS121190","article-title":"Endoscopic endonasal surgery for giant pituitary adenomas: Advantages and\n                    limitations","volume":"118","author":"M Koutourousiou","year":"2013","journal-title":"J Neurosurg"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"1255768","DOI":"10.3389\/fonc.2023.1255768","article-title":"Surgical management of giant pituitary adenomas: Institutional experience and\n                    clinical outcomes of 94 patients","volume":"13","author":"D Ke","year":"2023","journal-title":"Front Oncol"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"299","DOI":"10.3171\/jns.2002.97.2.0299","article-title":"Giant prolactinomas: Clinical management and long-term follow up","volume":"97","author":"R K Shrivastava","year":"2002","journal-title":"J Neurosurg"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"1433","DOI":"10.1210\/clinem\/dgad758","article-title":"Presurgical medical treatment in prolactinomas: Surgical implications and\n                    pathological characteristics from 290 cases","volume":"109","author":"Z Chen","year":"2024","journal-title":"J Clin Endocrinol Metab"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"314","DOI":"10.1038\/s41574-024-00976-y","article-title":"Tumour fibrosis in dopamine agonist-exposed prolactinomas is a diminishing\n                    concern","volume":"20","author":"SM C De Sousa","year":"2024","journal-title":"Nat Rev Endocrinol"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1016\/j.wneu.2015.10.090","article-title":"Cost-effectiveness analysis of microscopic and endoscopic transsphenoidal\n                    surgery versus medical therapy in the management of microprolactinoma in the\n                    United States","volume":"87","author":"P R Jethwa","year":"2016","journal-title":"World Neurosurg"}],"container-title":["Experimental and Clinical Endocrinology &amp; Diabetes"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/www.thieme-connect.de\/products\/ejournals\/pdf\/10.1055\/a-2364-6027.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,5]],"date-time":"2024-11-05T14:37:42Z","timestamp":1730817462000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.thieme-connect.de\/DOI\/DOI?10.1055\/a-2364-6027"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,11]]},"references-count":46,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2024,10,9]]},"published-print":{"date-parts":[[2024,10]]}},"URL":"https:\/\/doi.org\/10.1055\/a-2364-6027","archive":["Portico","CLOCKSS"],"relation":{},"ISSN":["0947-7349","1439-3646"],"issn-type":[{"type":"print","value":"0947-7349"},{"type":"electronic","value":"1439-3646"}],"subject":[],"published-other":{"date-parts":[[2024,7,11]]},"published":{"date-parts":[[2024,7,11]]}}}