Long-term Follow-up of 84 Patients With Giant Prolactinomas—A Swedish Nationwide Study
Authors' conclusion
DAs effectively reduced PRL and tumor size, but approximately 1 patient out of 4 needed multimodal treatment. Our results suggest that the response to DA after 1 year is useful for identifying patients who need more careful monitoring and, in some cases, additional treatment.
Study context
- Population
- Patients with giant prolactinomas (serum prolactin (PRL) > 1000 µg/L, tumor diameter ≥40 mm), Swedish Pituitary Register 1991–2018; mean age 47 (SD ±16) years, 89% men
- Participants
- 84 patients
- Outcome
- Treatment outcomes at last follow-up
- Follow-up
- Median 9 years (IQR 4-15)
Main finding
As reported in the abstract
- PRL at last follow-up, median (IQR 4-126)
- 12 µg/L
- Tumor diameter at last follow-up, median (IQR 3-40)
- 22 mm
- Normalized PRL
- 55%
- Significant tumor reduction
- 69%
- Combined response (normalized PRL and significant tumor reduction)
- 43%
Observational data: associations, not effects.
Further findings
Presentation at diagnosis
- PRL, median (range 1450-253 000)
- 6305 µg/L
- Tumor diameter, median (range 40-85)
- 47 mm
- Hypogonadotropic hypogonadism
- 84%
- Visual field defects
- 71%
Treatment
- Received ≥1 additional therapies
- 23 (27%)
- Surgery
- n = 19
- Radiotherapy
- n = 6
- Other medical treatments
- n = 4
- Chemotherapy
- n = 2
- Ki-67 ≥10%
- 4/14 tumors
- All patients treated with a dopamine agonist (DA) at some point
Predictors of combined response at last follow-up in primary DA-treated patients (n = 79) · after the first year
- Reduction in PRL after first year predicted combined response
- P < 0.001
- Reduction in tumor size after first year predicted combined response
- P = 0.012
Original publication
Long-term Follow-up of 84 Patients With Giant Prolactinomas—A Swedish Nationwide Study. J Clin Endocrinol Metab. Published 4 July 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →