{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T01:59:13Z","timestamp":1773712753812,"version":"3.50.1"},"reference-count":36,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2014,3,13]],"date-time":"2014-03-13T00:00:00Z","timestamp":1394668800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2014,7]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Macroprolactinomas are pituitary tumours that can be managed with dopamine agonists (<jats:styled-content style=\"fixed-case\">DA<\/jats:styled-content>), surgery and radiotherapy. We aimed to assess the outcomes of these treatment modalities.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Retrospective case\u2010note study of patients managed in a single tertiary referral centre.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients<\/jats:title><jats:p>One hundred patients (68 male) diagnosed with macroprolactinoma between 1971 and 2009.<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements<\/jats:title><jats:p>We assessed the response to first\u2010line treatment in terms of reduction in serum prolactin, endocrine status, symptomatic improvement and tumour shrinkage. Patients were divided into a group that received only <jats:styled-content style=\"fixed-case\">DA<\/jats:styled-content> therapy and a group that received surgery, radiotherapy or both, with or without a <jats:styled-content style=\"fixed-case\">DA<\/jats:styled-content>. We compared pituitary function at baseline and at last clinic visit between the two groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, there were 1170 patient years of follow\u2010up. Pituitary surgery was performed in 29\/100 patients. Fourteen patients received pituitary radiotherapy (8\/14 surgery also). At last clinic visit, the nonmedical therapy group had a higher risk of gonadotrophin deficiency (77\u00b74% <jats:italic>vs<\/jats:italic> 44\u00b78%, <jats:italic>P<\/jats:italic>\u00a0=\u00a00\u00b70037), <jats:styled-content style=\"fixed-case\">TSH<\/jats:styled-content> deficiency (54\u00b78% <jats:italic>vs<\/jats:italic> 25\u00b74%, <jats:italic>P<\/jats:italic>\u00a0=\u00a00\u00b70009) and <jats:styled-content style=\"fixed-case\">ACTH<\/jats:styled-content> deficiency (56\u00b72% <jats:italic>vs<\/jats:italic> 17\u00b72%, <jats:italic>P<\/jats:italic>\u00a0=\u00a00\u00b70001). When last reviewed, 23\/29 (79\u00b73%) patients who underwent surgery and 10\/14 (71\u00b74%) patients who received radiotherapy were taking a <jats:styled-content style=\"fixed-case\">DA<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Treatment with a <jats:styled-content style=\"fixed-case\">DA<\/jats:styled-content> alone is associated with better outcomes in terms of pituitary function and as such represents the optimal first\u2010line therapy for macroprolactinomas. Surgery and radiotherapy should be reserved for patients who are either intolerant of or resistant to <jats:styled-content style=\"fixed-case\">DA<\/jats:styled-content>s. Following surgery and\/or radiotherapy, the majority of patients still require a <jats:styled-content style=\"fixed-case\">DA<\/jats:styled-content> for control of prolactin hypersecretion.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.12418","type":"journal-article","created":{"date-parts":[[2014,1,31]],"date-time":"2014-01-31T17:14:59Z","timestamp":1391188499000},"page":"85-92","source":"Crossref","is-referenced-by-count":11,"title":["Extensive experience in the management of macroprolactinomas"],"prefix":"10.1111","volume":"81","author":[{"given":"Anna I.","family":"Green","sequence":"first","affiliation":[{"name":"Department of Endocrinology Queen Elizabeth Hospital University Hospital Birmingham NHS Foundation Trust Birmingham UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Sherlock","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Queen Elizabeth Hospital University Hospital Birmingham NHS Foundation Trust Birmingham UK"},{"name":"Department of Endocrinology Adelaide and Meath Hospital Incorporating the National Children's Hospital Dublin Ireland"},{"name":"Trinity College Dublin Ireland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul M.","family":"Stewart","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Queen Elizabeth Hospital University Hospital Birmingham NHS Foundation Trust Birmingham UK"},{"name":"Centre for Endocrinology Diabetes and Metabolism University of Birmingham Birmingham UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neil J.","family":"Gittoes","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Queen Elizabeth Hospital University Hospital Birmingham NHS Foundation Trust Birmingham UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew A.","family":"Toogood","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Queen Elizabeth Hospital University Hospital Birmingham NHS Foundation Trust Birmingham UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,3,13]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.beem.2009.05.003"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa022657"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1210\/er.2005-9998"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.85.6.2247"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1210\/jcem.86.11.8054"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa062222"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(04)15945-X"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa054830"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2008.163345"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2009-2095"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.304.6838.1343"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1677\/ERC-08-0231"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tem.2005.09.008"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0360-3016(97)00335-0"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2004-1152"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1210\/er.2009-0033"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(00)04006-X"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.2006.02562.x"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.4065\/73.11.1046"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.82.7.2102"},{"key":"e_1_2_7_22_1","first-page":"152","article-title":"Gender\u2010related differences in prolactinomas. 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