SynthesisThe Journal of clinical endocrinology and metabolism2020
Surgery as a Viable Alternative First-Line Treatment for Prolactinoma Patients. A Systematic Review and Meta-Analysis.
Synthesis in The Journal of clinical endocrinology and metabolism, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 71 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
71 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- How to Define Success in Prolactinoma Treatment-A Systematic Review and Theoretical Framework.The Journal of clinical endocrinology and metabolism · 2026Pooled it
- Consensus guideline for the diagnosis and management of pituitary adenomas in childhood and adolescence: Part 2, specific diseases.Nature reviews. Endocrinology · 2024Guideline
- Italian Guidelines for the Management of Prolactinomas.Endocrine, metabolic & immune disorders drug targets · 2023Guideline
- Surgical outcomes of medically failed prolactinomas: a systematic review and meta-analysis.Pituitary · 2021Pooled it
- Functional pituitary adenoma imaging.Reviews in endocrine & metabolic disorders · 2026Review
- Article
- Chinese consensus on the diagnosis and treatment of prolactinomas (2025 edition).Chinese neurosurgical journal · 2026Review
- Determinants of remission and recurrence following transsphenoidal surgery for prolactinoma: a single-center experience.Pituitary · 2026Article
- Identification of biomarkers associated with integrated stress response in pituitary adenomas based on bioinformatics.Discover oncology · 2026Article
- The clinical value of [Pituitary · 2026Observational
- Exploring the Role of Intraoperative Prolactin Levels in Surgical Management of Prolactinomas: Predicting Operative Success and Enhancing Surgical Decision-Making.Journal of neurological surgery. Part B, Skull base · 2026Article
- Long-term cabergoline use does not predict degree of prolactinoma fibrosis nor significantly impact surgical outcomes.Pituitary · 2026Article
- Subtle Cognitive Impairments and Psychological Complaints in Patients With Prolactinoma Despite Biochemical Control.The Journal of clinical endocrinology and metabolism · 2025Article
- Management outcomes of prolactinoma: a retrospective study from Southern Iraq.Journal of medicine and life · 2025Article
- Endoscopic endonasal transcavernous surgery for a contemporary series of 59 prolactinomas.Pituitary · 2025Article
- The Changing Treatment Paradigm for Prolactinoma-A Prospective Series of 100 Consecutive Neurosurgical Cases.The Journal of clinical endocrinology and metabolism · 2025Article
- Cabergoline-induced cerebrospinal fluid fistulae in macroprolactinomas.Langenbeck's archives of surgery · 2025Article
- Predictors of favorable long-term outcomes in first-line surgery for microprolactinomas.Journal of neuro-oncology · 2025Article
- A Narrative Review of Surgery for Prolactinomas: Considerations and Controversies.Journal of clinical medicine · 2025Review
- Outcomes in surgical management of microprolactinomas: an international multi-institutional series.Pituitary · 2025Article
11 more citing papers are in PubMed but not listed here.
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10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
contextThe improved remission and complication rates of current transsphenoidal surgery warrant reappraisal of the position of surgery as a viable alternative to dopamine agonists in the treatment algorithm of prolactinomas.
objectiveTo compare clinical outcomes after dopamine agonist withdrawal and transsphenoidal surgery in prolactinoma patients.
methodsEight databases were searched up to July 13, 2018. Primary outcome was disease remission after drug withdrawal or surgery. Secondary outcomes were biochemical control and side effects during dopamine agonist treatment and postoperative complications. Fixed- or random-effects meta-analysis was performed to estimate pooled proportions. Robustness of results was assessed by sensitivity analyses.
resultsA total of 1469 articles were screened: 55 (10 low risk of bias) on medical treatment (n = 3564 patients) and 25 (12 low risk of bias) on transsphenoidal surgery (n = 1836 patients). Long-term disease remission after dopamine agonist withdrawal was 34% (95% confidence interval [CI], 26-46) and 67% (95% CI, 60-74) after surgery. Subgroup analysis of microprolactinomas showed 36% (95% CI, 21-52) disease remission after dopamine agonist withdrawal, and 83% (95% CI, 76-90) after surgery. Biochemical control was achieved in 81% (95% CI, 75-87) of patients during dopamine agonists with side effects in 26% (95% CI, 13-41). Transsphenoidal surgery resulted in 0% mortality, 2% (95% CI, 0-5) permanent diabetes insipidus, and 3% (95% CI, 2-5) cerebrospinal fluid leakage. Multiple sensitivity analyses yielded similar results.
conclusionsIn the majority of prolactinoma patients, disease remission can be achieved through surgery, with low risks of long-term surgical complications, and disease remission is less often achieved with dopamine agonists.
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