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Strategies for treatment of prolactinomas

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Author:
No author available
Journal Title:
Chinese Journal of Neurosurgery
Issue:
4
DOI:
10.3760/cma.j.issn.1001-2346.2012.04.005
Key Word:
催乳素瘤;显微外科手术;多巴胺受体激动剂;放射治疗;Prolactinoma;Microsurgery;Dopamine receptor agonists;Radio therapy

Abstract: Objective To observe the long - term follow - up outcomes of surgical treatment of prolactinomas and explore the optimal individual - based and standardized therapy suitable for patients with prolactinomas.Methods 756 patients were operated in Beijing Tiantan Hospital for pituitary adenomas.Among which 158 cases (male 56 cases,female 102cases) with pathologically proved prolactinoma were retrospectively analyzed.The changes of serum PRL level after surgery were analyzed and the efficacy of surgery was observed in the follow - up period ( 12 - 45 months).Results The rates of total resection,subtotal resection and partial resection were 81.6%,15.2%,3.2% respectively.There was no death.The postoperative PRL levels in 134 cases(84.8% ) were decreased to normal within 7 days after surgery.The incidence of diabetes insipidus ( 10.8% ) and electrolyte disturbances ( 15.2% ) were more common seen than the other complications.The cure rates of 0.5,1,2 years were 83.5%,80.4% and 78.7%respectively.Conclusions The outcomes of surgical treatment for prolactinomas are similar to those with dopamine agonists in long - term follow - up.Indications for surgery should be controlled stringently.Surgery is not the first - line therapy for patients with microadenomas ( ≤ 1cm).It should be carefully considered about radiotherapy.Individual - based therapy should be adopted specifically according to the actual clinical conditions of different patients.

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