Outcomes in surgical management of microprolactinomas: an international multi-institutional series
Authors' conclusion
With a surgical remission rate of nearly 70%, EES represents a safe and viable alternative strategy to long-term DA treatment for microprolactinomas.
Study context
- Population
- Adults who underwent endoscopic endonasal surgery (EES) for microprolactinoma at three medical centers, 2010–2021; mean age 32.9 years; 98.2% on dopamine agonists (DAs) preoperatively
- Participants
- 56 adults
- Outcome
- Surgical failure: need to restart DAs, serum prolactin >30ng/mL at last follow-up, tumor recurrence, or need for reoperation
- Follow-up
- Mean 26.4 months
Methodological detailsmulticentre, retrospective chart review
- Multicentre
- Retrospective chart review
Main finding
As reported in the abstract
Surgical failure (need to restart DAs, prolactin >30ng/mL at last follow-up, recurrence or reoperation) · last follow-up; mean 26.4 months
- Overall surgical remission rate
- ≈70%
- Surgical failure
- 17 (30.4%) patients
- Subtotal resection the only independent predictor of surgical failure (multivariate logistic regression)
- p = 0.038*
Observational data: associations, not effects.
Further findings
- Gross total resection achieved
- 51 (91.1%) cases
Safety
Postoperative complications
- Transient arginine vasopressin deficiency (AVP-D) (most common)
- 21.4%
- Permanent AVP-D, new visual deficits or cerebrospinal fluid leak
- 0
Original publication
Outcomes in surgical management of microprolactinomas: an international multi-institutional series. Pituitary. Published 3 February 2025. doi:10.
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