Conclusions
This retrospective series of 56 prolactinoma patients treated surgically at a tertiary pituitary center suggests that surgical resection can be an effective treatment for prolactinoma patients. CSI status, tumor size, POD1 prolactin levels, and EOR can be used to predict surgical cure. In particular, POD1 prolactin levels greater than 7.6 ng/mL can reliably predict that a patient will not attain surgical cure. We suggest that significant preoperative prolactin elevations (> 500 ng/mL for surgical cure and > 1000 ng/mL for biochemical control regardless of postoperative DA therapy) may decrease the likelihood of surgical cure or biochemical control irrespective of DA therapy. Although surgical resection of prolactinomas is safe at experienced pituitary centers, it should be reserved for selected cases in which patients can achieve disease control, relief of symptoms of mass effect, or reduction of DA dosage. Realistic outcomes regarding biochemical control and ongoing dependence on medications should be provided to patients to aid in decision making.
Abbreviations
CSI, cavernous sinus invasion; DA, dopamine agonist; DI, diabetes insipidus; EMR, electronic medical record; EOR, extent of resection; GTR, gross total resection; MRI, magnetic resonance imaging; POD, postoperative day; SRS, stereotactic radiosurgery; STR, subtotal resection; TSSR, transsphenoidal surgical resection; USC, University of Southern California.
Additional Information
Data Availability
Restrictions apply to the availability of some or all data generated or analyzed during this study to preserve patient confidentiality or because they were used under license. The corresponding author will on request detail the restrictions and any conditions under which access to some data may be provided.
J Endo Soc. 2021;5(10) © 2021 Endocrine Society