{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T17:44:12Z","timestamp":1776793452811,"version":"3.51.2"},"reference-count":39,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2021,10,26]],"date-time":"2021-10-26T00:00:00Z","timestamp":1635206400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100008005","name":"Yonsei University","doi-asserted-by":"publisher","award":["6-2021-0009"],"award-info":[{"award-number":["6-2021-0009"]}],"id":[{"id":"10.13039\/501100008005","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100008005","name":"Yonsei University","doi-asserted-by":"publisher","award":["4-2018-1215;DUCD000002"],"award-info":[{"award-number":["4-2018-1215;DUCD000002"]}],"id":[{"id":"10.13039\/501100008005","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","award":["2020R1I1A1A01071648"],"award-info":[{"award-number":["2020R1I1A1A01071648"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Predicting dopamine agonist resistance in patients with macroprolactinoma is essential for clinicians to prevent treatment failure and subsequent complications such as medication-induced cerebrospinal fluid (CSF) rhinorrhea. We evaluated the features of patients with cabergoline resistance and CSF rhinorrhea in patients with prolactinomas with prolactin levels \u22651000 ng\/mL. A total of 140 patients who were newly diagnosed with prolactinoma secreting only prolactin \u22651000 ng\/mL and treated with cabergoline for the first time were included in this study. Based on the hormonal and radiologic response of the prolactinoma, the patients were divided into responders and non-responders. Non-responders (36\/140, 25.8%) included a higher number of patients receiving hormone replacement than responders (responders, n (%) = 12(11.5) vs. non-responders = 13(36.1), p = 0.001). In propensity score matching analysis, patients who developed CSF rhinorrhea presented more frequent hormone deficiency than responders regardless of initial cabergoline dose. Hormone deficiency was associated with a greater odds ratio for the risk of non-responders (adjusted odds ratio = 5.13, 95% CI 1.96\u201313.46, p = 0.001). Cabergoline was effective in bioactive macroprolactinoma. Furthermore, initial cabergoline dose was not significantly associated with long-term responsiveness and development of CSF rhinorrhea but the hypopituitarism was independently associated with an increased risk of cabergoline resistance and CSF rhinorrhea.<\/jats:p>","DOI":"10.3390\/cancers13215374","type":"journal-article","created":{"date-parts":[[2021,10,26]],"date-time":"2021-10-26T23:49:52Z","timestamp":1635292192000},"page":"5374","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Efficacy and Cerebrospinal Fluid Rhinorrhea after Cabergoline Treatment in Patients with Bioactive Macroprolactinoma"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5130-4245","authenticated-orcid":false,"given":"Hae-Kyung","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Institute of Endocrine Research, Yonsei University College of Medicine, Seoul 03722, Korea"},{"name":"Pituitary Tumor Center, Severance Hospital, Seoul 03722, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jae-Won","family":"Hong","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Endocrinology, Ilsan-Paik Hospital, Inje University College of Medicine, 170 Juhawro, Ilsanseo-gu, Goyang 10380, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ju-Hyung","family":"Moon","sequence":"additional","affiliation":[{"name":"Pituitary Tumor Center, Severance Hospital, Seoul 03722, Korea"},{"name":"Department of Neurosurgery, Yonsei University College of Medicine, Seoul 03722, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sung-Soo","family":"Ahn","sequence":"additional","affiliation":[{"name":"Pituitary Tumor Center, Severance Hospital, Seoul 03722, Korea"},{"name":"Center for Clinical Imaging Data Science, Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul 03722, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2523-7122","authenticated-orcid":false,"given":"Eui-Hyun","family":"Kim","sequence":"additional","affiliation":[{"name":"Pituitary Tumor Center, Severance Hospital, Seoul 03722, Korea"},{"name":"Department of Neurosurgery, Yonsei University College of Medicine, Seoul 03722, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seung-Koo","family":"Lee","sequence":"additional","affiliation":[{"name":"Pituitary Tumor Center, Severance Hospital, Seoul 03722, Korea"},{"name":"Center for Clinical Imaging Data Science, Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul 03722, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eun-Jig","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Institute of Endocrine Research, Yonsei University College of Medicine, Seoul 03722, Korea"},{"name":"Pituitary Tumor Center, Severance Hospital, Seoul 03722, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yae-Won","family":"Park","sequence":"additional","affiliation":[{"name":"Pituitary Tumor Center, Severance Hospital, Seoul 03722, Korea"},{"name":"Center for Clinical Imaging Data Science, Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul 03722, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8693-9630","authenticated-orcid":false,"given":"Cheol-Ryong","family":"Ku","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Institute of Endocrine Research, Yonsei University College of Medicine, Seoul 03722, Korea"},{"name":"Pituitary Tumor Center, Severance Hospital, Seoul 03722, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,10,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"R213","DOI":"10.1530\/EJE-14-0013","article-title":"Therapy of endocrine disease: The challenges in managing giant prolactinomas","volume":"170","author":"Maiter","year":"2014","journal-title":"Eur. 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