Endoscopic endonasal transcavernous surgery for a contemporary series of 59 prolactinomas
Authors' conclusion
The addition of endoscopic transcavernous approaches for prolactinoma resection can be safe and effective in selected patients after multidisciplinary evaluation when performed by an experienced neurosurgical team, providing further support for the wider adoption of surgery in the management of prolactinomas.
Study context
- Population
- Consecutive patients with prolactinomas undergoing endoscopic endonasal surgery, October 2018–December 2024; 71% macroprolactinomas, 54% with cavernous sinus (CS) invasion
- Participants
- 59 consecutive patients
- Outcome
- Biochemical remission at last follow-up
- Follow-up
- Median 19 months (IQR 10-38)
Methodological detailsconsecutive patients, single surgical series
- Consecutive patients
- Single surgical series
Main finding
As reported in the abstract
Biochemical remission at last follow-up, overall
80%
Biochemical remission, macroprolactinoma
74%
Biochemical remission, microprolactinoma
94%
Normoprolactinemia within 3 days of surgery
82%
Observational data: associations, not effects.
Further findings
Long-term remission with adjuvant dopamine agonist and/or radiation
- Overall
- 86%
- Macroprolactinomas
- 83%
Long-term biochemical remission where total resection (vs debulking) was the primary surgical goal
- Remission
- 84%
- Remission with adjuvant therapy
- 88%
Safety
- Operative complication with no neurological sequelae (giant invasive adenoma)
- 1 patient
- Permanent AVP-D
- 3 patients
- Transient diplopia
- 4 patients
Original publication
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