{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T05:24:05Z","timestamp":1781587445445,"version":"3.54.5"},"reference-count":90,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Although dopamine agonist (DA) therapy still represents the standard of care for prolactinomas, a reconsideration of the role of transsphenoidal surgery has been promoted in recent years. The aim of this multicenter retrospective study was to assess the short- and long-term results of the endoscopic endonasal approach (EEA) for prolactinomas, analyzing which factors have a favorable prognostic role.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>All consecutive prolactinomas operated on in 12 Italian neurosurgical centers between 2013 and 2023 were included. For each case, preoperative clinical and neuroradiological features were considered, as well as surgical complications and short- and long-term results.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>The series included 215 patients (44.2% males, mean age 39.7 [SD 16.6] years), accounting for 4.5% of all pituitary surgeries in these centers. The majority of prolactinomas (67.9%) were macroprolactinomas. Radical tumor resection was achieved in 171 patients (79.5%), and 3-month biochemical remission in 154 patients (71.6%). The most common surgical complication was postoperative CSF leak (2.8%). Endocrinological sequelae consisted of new onset of anterior hypopituitarism in 10.7% of cases, transient diabetes insipidus (DI) in 3.3%, and permanent DI in 2.3%. Long-term remission (mean follow-up 33.5 [SD 25.0] months) was achieved in 75.4% of patients, 14 patients (6.5%) presented with tumor recurrence\/progression, and 1 (0.5%) demonstrated tumor evolution to carcinoma.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>The EEA is a valid option for the treatment of prolactinomas, with better results for micro tumors and regular macro tumors. This study found that preoperative prolactin values &lt; 184 ng\/ml were associated with higher chances of biochemical remission, as was larger pituitary surgery center volume. Currently, the most common surgical indications for prolactinomas are represented by cases that are not responsive or intolerant to DAs. However, interesting future perspectives considering EEA as a possible co\u2013first-line therapy in selected patients have been recently proposed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2025.7.jns242821","type":"journal-article","created":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T17:26:26Z","timestamp":1765214786000},"page":"611-623","source":"Crossref","is-referenced-by-count":2,"title":["Endoscopic endonasal surgery for prolactin-secreting adenoma: a retrospective multicenter study by the neuroendoscopy section of the Italian Society of Neurosurgery"],"prefix":"10.3171","volume":"144","author":[{"given":"Matteo","family":"Zoli","sequence":"first","affiliation":[{"name":"Programma Neurochirurgia Ipofisi, IRCCS Istituto delle Scienze Neurologiche di Bologna;"},{"name":"Department of Bio-Medical and Neuro-Motor Sciences, University of Bologna;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filippo Flavio","family":"Angileri","sequence":"additional","affiliation":[{"name":"Neurosurgery Unit, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina","family":"Cappelletti","sequence":"additional","affiliation":[{"name":"UOC Neurochirurgia, Ospedale Ca\u2019 Foncello, AULSS2 Marca Trevigiana, Treviso;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Doglietto","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Universit\u00e0 Cattolica del Sacro Cuore, Rome;"},{"name":"Neurosurgery Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Fiorindi","sequence":"additional","affiliation":[{"name":"Neurosurgical Unit, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Spedali Civili, Brescia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cosimo Damiano","family":"Gianfreda","sequence":"additional","affiliation":[{"name":"Neurosurgery Unit, \"V. Fazzi\" Hospital, Lecce;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liverana","family":"Lauretti","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Universit\u00e0 Cattolica del Sacro Cuore, Rome;"},{"name":"Neurosurgery Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Massimi","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Universit\u00e0 Cattolica del Sacro Cuore, Rome;"},{"name":"Pediatric Neurosurgery, Fondazione Policlinico Universitario Agostini Gemelli IRCCS, Rome;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelo","family":"Musumeci","sequence":"additional","affiliation":[{"name":"Institute of Neurosurgery, University Hospital of Verona;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Peron","sequence":"additional","affiliation":[{"name":"UOC Neurochirurgia, ASST Ovest Milanese, Milan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Tropeano","sequence":"additional","affiliation":[{"name":"Neurosurgery Department, IRCCS Humanitas Research Hospital, Milan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corrado","family":"Zenesini","sequence":"additional","affiliation":[{"name":"Epidemiology and Statistics Unit, IRCCS Istituto delle Scienze Neurologiche di Bologna;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cesare","family":"Zoia","sequence":"additional","affiliation":[{"name":"Neurosurgery Department, Fondazione IRCCS Policlinico San Matteo, Pavia; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luigi Maria","family":"Cavallo","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Department of Neurosciences and Reproductive and Dental Sciences, Federico II University of Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diego","family":"Mazzatenta","sequence":"additional","affiliation":[{"name":"Programma Neurochirurgia Ipofisi, IRCCS Istituto delle Scienze Neurologiche di Bologna;"},{"name":"Department of Bio-Medical and Neuro-Motor Sciences, University of Bologna;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"_","family":"_","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Viola","family":"Bartoletti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Belotti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"D\u2019Avella","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Lasio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pier Paolo","family":"Mattogno","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aristide","family":"Nanni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simona","family":"Serioli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giannantonio","family":"Spena","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Stefini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianpiero","family":"Tamburrini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mattia","family":"Testa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"3","key":"b1","series-title":"Endocrinol Metab Clin North Am","first-page":"347","article-title":"The epidemiology of pituitary adenomas","volume":"49","author":"Daly AF","year":"2020","unstructured":"Daly AF, Beckers A. 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