Long-term response to cabergoline and multi-modal treatment in men with macroprolactinoma: Does size really matter?
cabergoline
men
pituitary macroadenoma
prolactin
prolactinoma
Journal
Clinical endocrinology
ISSN: 1365-2265
Titre abrégé: Clin Endocrinol (Oxf)
Pays: England
ID NLM: 0346653
Informations de publication
Date de publication:
10 2021
10 2021
Historique:
revised:
27
05
2021
received:
15
03
2021
accepted:
02
06
2021
pubmed:
24
6
2021
medline:
28
10
2021
entrez:
23
6
2021
Statut:
ppublish
Résumé
To study the outcome of men with macroprolactinoma following cabergoline treatment based on tumour size. Retrospective cohort study. The study included 94 men, divided into three groups according to adenoma diameter: 10-19 mm (Group A, n = 36); 20-39 mm (Group B, n = 41); or ≥40 mm (Group C, giant prolactinomas, n = 17). Patients were followed for a mean of 7.5 years with sellar magnetic resonance imaging, visual fields and hormone measurements. Mean baseline prolactin was 767, 2090 and 24,806 ng/ml in Groups A, B and C, respectively (p < .01). Prolactin suppression below three times the upper limit of normal (ULN) was achieved in 34 (94%; mean weekly cabergoline dose of 1.2 mg), 37 (90%; cabergoline dose, 2.1 mg) and 15 (88%; cabergoline dose, 2.8 mg) men (p = .31) in each group. After excluding patients who underwent surgery and radiotherapy, cabergoline suppressed prolactin below three times ULN in 32/35 (91%), 29/37 (78%) and 11/14 (79%) men in Groups A, B and C, respectively (p = .27). Visual deficits were observed in 5 (14%), 12 (29%) and 10 (59%) patients (p < .01); improvement was achieved in 5/5 (100%), 11/12 (92%) and 10/10 (100%) of men in Groups A, B and C. Low baseline testosterone was measured in 26 (72%), 39 (95%) and 17 (100%) patients in the three groups (p < .01). Following multi-modal treatment, hypogonadism persisted in 3 (8%), 5 (12%) and 2 (12%) men, respectively (p = .85). Macroprolactinomas in men were controlled with cabergoline in 84% of cases, independent of tumour size. Pituitary surgery and adjuvant radiotherapy further improved long-term response to 91%.
Substances chimiques
Dopamine Agonists
0
Ergolines
0
Prolactin
9002-62-4
Cabergoline
LL60K9J05T
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
606-617Informations de copyright
© 2021 John Wiley & Sons Ltd.
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