Evidence map›Paper›PMID 37940745›Full record

ArticleNeurosurgical review2023

Endoscopic endonasal surgery for prolactinomas: prognostic factors for disease control and management of persistent disease.

Aristotelis Kalyvas, Joao Paulo Almeida, Farshad Nassiri, Ruth Lau, Philip J O'Halloran, Nilesh Mohan, Thomas Wälchli, Vincent C Ye, Dennis M Tang, Pranay Soni and 6 more

Abstract read
PubMed Publisher
In one paragraph

Article in Neurosurgical review, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Aristotelis KalyvasDivision of Neurosurgery, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, ON, Canada. aristoteliskalyvas@gmail.com.
Joao Paulo AlmeidaDepartment of Neurosurgery, Mayo Clinic, Jacksonville, FL, USA.
Farshad NassiriDivision of Neurosurgery, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, ON, Canada.
Ruth LauDivision of Neurosurgery, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, ON, Canada.
Philip J O'HalloranDivision of Neurosurgery, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, ON, Canada.
Nilesh MohanDivision of Neurosurgery, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, ON, Canada.
Thomas WälchliDivision of Neurosurgery, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, ON, Canada.
Vincent C YeDivision of Neurosurgery, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, ON, Canada.
Dennis M TangDivision of Otolaryngology, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Pranay SoniDepartment of Neurological Surgery, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA.
Tamia PotterSchool of Medicine, Case Western Reserve University, Cleveland, OH, USA.
Shereen EzzatEndocrine Oncology Site, Princess Margaret Cancer Center, University Health Network, University of Toronto, Toronto, ON, Canada.
Varun R KshettryDepartment of Neurological Surgery, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA.
Gelareh ZadehDivision of Neurosurgery, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, ON, Canada.
Pablo F RecinosDepartment of Neurological Surgery, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA.
Fred GentiliDivision of Neurosurgery, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, ON, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Only a limited number of studies have focused on the results of the Endoscopic Endonasal Approach (EEA) for treatment of prolactinomas. We sought to assess the effectiveness of EEA for prolactinoma surgery, identify factors for disease remission, and present our approach for the management of persistent disease. Forty-seven prolactinomas operated over 10 years, with a mean follow-up of 59.9 months, were included. The primary endpoints were early disease remission and remission at last follow-up. Resistance/intolerance to DA were surgical indications in 76.7%. Disease remission was achieved in 80% of microprolactinomas and 100% of microprolactinomas enclosed by the pituitary. Early disease remission was correlated with female gender (p=0.03), lower preoperative PRL levels (p=0.014), microadenoma (p=0.001), lack of radiological hemorrhage (p=0.001), absence of cavernous sinus (CS) invasion (p<0.001), and extent of resection (EOR) (p<0.001). Persistent disease was reported in 48.9% of patients, with 47% of them achieving remission at last follow-up with DA therapy alone. Repeat EEA and/or radiotherapy were utilized in 6 patients, with 66.7% achieving remission. Last follow-up remission was achieved in 76.6%, with symptomatic improvement in 95.8%. Factors predicting last follow-up remission were no previous operation (p=0.001), absence of CS invasion (p=0.01), and EOR (p<0.001). Surgery is effective for disease control in microprolactinomas. In giant and invasive tumors, it may significantly reduce the tumor volume. A multidisciplinary approach may lead to long-term disease control in three-quarters of patients, with symptomatic improvement in an even greater proportion.

Indexed as

Pituitary NeoplasmsProlactinomaFemaleHumansPrognosisRetrospective StudiesTreatment OutcomeEndonasalEndoscopicLactotroph adenomaPituitary tumorProlactinomaTranssphenoidal

Identifiers

PMID37940745

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.