Treatment of Prolactinomas in Low-Income Countries
Purpose. In low-income countries, prolactinomas are difficult to manage with dopamine agonists (DA). We compared the effectiveness of DA in microprolactinomas as a first line treatment and as adjuvant therapy for residual macroprolactinomas treated surgically. Methods. Our retrospective study analyz...
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| Format: | Article |
| Language: | English |
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Wiley
2015-01-01
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| Series: | International Journal of Endocrinology |
| Online Access: | http://dx.doi.org/10.1155/2015/697065 |
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| author | Ivan Kruljac Lora Stanka Kirigin Mateja Strinović Jelena Marinković Hrvoje Ivan Pećina Vatroslav Čerina Darko Stipić Milan Vrkljan |
| author_facet | Ivan Kruljac Lora Stanka Kirigin Mateja Strinović Jelena Marinković Hrvoje Ivan Pećina Vatroslav Čerina Darko Stipić Milan Vrkljan |
| author_sort | Ivan Kruljac |
| collection | DOAJ |
| description | Purpose. In low-income countries, prolactinomas are difficult to manage with dopamine agonists (DA). We compared the effectiveness of DA in microprolactinomas as a first line treatment and as adjuvant therapy for residual macroprolactinomas treated surgically. Methods. Our retrospective study analyzed 78 patients, 38 with microprolactinomas and 40 with macroprolactinomas. Microprolactinomas were treated with DA. Macroprolactinomas were treated with microsurgical or endoscopic adenomectomies and adjuvant DA. Surgical remission was defined as normoprolactinemia three months postoperatively, and long-term remission as normoprolactinemia at the last control. Results. Surgical remission was achieved in 9 patients (23%). Postsurgical tumor mass was reduced by 50% (34–68). Residual macroprolactinoma size was greater than microprolactinoma size prior to treatment (10 mm versus 4 mm, P<0.001). Both groups received similar doses of DA. Long-term remission occurred in 68% of microprolactinomas and 43% of macroprolactinomas (P=0.102). Prolactin (PRL) levels at the last control were similar in both groups (23.1 versus 32.9 mcg/L, P=0.347). Conclusion. Comparable remission rates and PRL levels were reached in microprolactinomas and macroprolactinomas using similar doses of DA. Although complete tumor resection is the goal of surgery, our study suggests that even partial surgical removal has a role in treatment of prolactinomas since it may enhance the response to DA. |
| format | Article |
| id | doaj-art-db48be7df6d842a39b2fefaf8df35a6f |
| institution | OA Journals |
| issn | 1687-8337 1687-8345 |
| language | English |
| publishDate | 2015-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | International Journal of Endocrinology |
| spelling | doaj-art-db48be7df6d842a39b2fefaf8df35a6f2025-08-20T02:21:17ZengWileyInternational Journal of Endocrinology1687-83371687-83452015-01-01201510.1155/2015/697065697065Treatment of Prolactinomas in Low-Income CountriesIvan Kruljac0Lora Stanka Kirigin1Mateja Strinović2Jelena Marinković3Hrvoje Ivan Pećina4Vatroslav Čerina5Darko Stipić6Milan Vrkljan7Department of Endocrinology, Diabetes and Metabolic Diseases “Mladen Sekso”, University Hospital Center “Sestre Milosrdnice”, University of Zagreb Medical School, Vinogradska Cesta 29, 10000 Zagreb, CroatiaDepartment of Endocrinology, Diabetes and Metabolic Diseases “Mladen Sekso”, University Hospital Center “Sestre Milosrdnice”, University of Zagreb Medical School, Vinogradska Cesta 29, 10000 Zagreb, CroatiaDepartment of Endocrinology, Diabetes and Metabolic Diseases “Mladen Sekso”, University Hospital Center “Sestre Milosrdnice”, University of Zagreb Medical School, Vinogradska Cesta 29, 10000 Zagreb, CroatiaDepartment of Endocrinology, Diabetes and Metabolic Diseases “Mladen Sekso”, University Hospital Center “Sestre Milosrdnice”, University of Zagreb Medical School, Vinogradska Cesta 29, 10000 Zagreb, CroatiaDepartment of Radiology, University Hospital Center “Sestre Milosrdnice”, Vinogradska Cesta 29, 10000 Zagreb, CroatiaDepartment of Neurosurgery, University Hospital Center “Sestre Milosrdnice”, Vinogradska Cesta 29, 10000 Zagreb, CroatiaDepartment of Neurosurgery, University Hospital Center “Sestre Milosrdnice”, Vinogradska Cesta 29, 10000 Zagreb, CroatiaDepartment of Endocrinology, Diabetes and Metabolic Diseases “Mladen Sekso”, University Hospital Center “Sestre Milosrdnice”, University of Zagreb Medical School, Vinogradska Cesta 29, 10000 Zagreb, CroatiaPurpose. In low-income countries, prolactinomas are difficult to manage with dopamine agonists (DA). We compared the effectiveness of DA in microprolactinomas as a first line treatment and as adjuvant therapy for residual macroprolactinomas treated surgically. Methods. Our retrospective study analyzed 78 patients, 38 with microprolactinomas and 40 with macroprolactinomas. Microprolactinomas were treated with DA. Macroprolactinomas were treated with microsurgical or endoscopic adenomectomies and adjuvant DA. Surgical remission was defined as normoprolactinemia three months postoperatively, and long-term remission as normoprolactinemia at the last control. Results. Surgical remission was achieved in 9 patients (23%). Postsurgical tumor mass was reduced by 50% (34–68). Residual macroprolactinoma size was greater than microprolactinoma size prior to treatment (10 mm versus 4 mm, P<0.001). Both groups received similar doses of DA. Long-term remission occurred in 68% of microprolactinomas and 43% of macroprolactinomas (P=0.102). Prolactin (PRL) levels at the last control were similar in both groups (23.1 versus 32.9 mcg/L, P=0.347). Conclusion. Comparable remission rates and PRL levels were reached in microprolactinomas and macroprolactinomas using similar doses of DA. Although complete tumor resection is the goal of surgery, our study suggests that even partial surgical removal has a role in treatment of prolactinomas since it may enhance the response to DA.http://dx.doi.org/10.1155/2015/697065 |
| spellingShingle | Ivan Kruljac Lora Stanka Kirigin Mateja Strinović Jelena Marinković Hrvoje Ivan Pećina Vatroslav Čerina Darko Stipić Milan Vrkljan Treatment of Prolactinomas in Low-Income Countries International Journal of Endocrinology |
| title | Treatment of Prolactinomas in Low-Income Countries |
| title_full | Treatment of Prolactinomas in Low-Income Countries |
| title_fullStr | Treatment of Prolactinomas in Low-Income Countries |
| title_full_unstemmed | Treatment of Prolactinomas in Low-Income Countries |
| title_short | Treatment of Prolactinomas in Low-Income Countries |
| title_sort | treatment of prolactinomas in low income countries |
| url | http://dx.doi.org/10.1155/2015/697065 |
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