dc.date.accessioned | 2024-03-02T16:46:02Z | |
dc.date.available | 2024-03-02T16:46:02Z | |
dc.date.created | 2023-12-20T14:12:37Z | |
dc.date.issued | 2023 | |
dc.identifier.citation | Himonakos, Christos Burman, Pia Borg, Henrik Dahlqvist, Per Engström, Britt Edén Ekman, Bertil Emilsson, Louise Olsson, Daniel S. Ragnarsson, Oskar Wahlberg, Jeanette Åkerman, Anna-Karin Höybye, Charlotte Berinder, Katarina . Long-term Follow-up of 84 Patients With Giant Prolactinomas-A Swedish Nationwide Study. Journal of Clinical Endocrinology and Metabolism (JCEM). 2023, 108(12), e1506-e1514 | |
dc.identifier.uri | http://hdl.handle.net/10852/108929 | |
dc.description.abstract | Abstract
Purpose
To describe the clinical presentation and treatment outcomes in a nationwide cohort of patients with giant prolactinomas.
Methods
Register-based study of patients with giant prolactinomas [serum prolactin (PRL) > 1000 µg/L, tumor diameter ≥40 mm] identified in the Swedish Pituitary Register 1991-2018.
Results
Eighty-four patients [mean age 47 (SD ±16) years, 89% men] were included in the study. At diagnosis, the median PRL was 6305 µg/L (range 1450-253 000), the median tumor diameter was 47 mm (range 40-85), 84% of the patients had hypogonadotropic hypogonadism, and 71% visual field defects. All patients were treated with a dopamine agonist (DA) at some point. Twenty-three (27%) received 1 or more additional therapies, including surgery (n = 19), radiotherapy (n = 6), other medical treatments (n = 4), and chemotherapy (n = 2). Ki-67 was ≥10% in 4/14 tumors. At the last follow-up [median 9 years (interquartile range (IQR) 4-15)], the median PRL was 12 µg/L (IQR 4-126), and the median tumor diameter was 22 mm (IQR 3-40). Normalized PRL was achieved in 55%, significant tumor reduction in 69%, and combined response (normalized PRL and significant tumor reduction) in 43%. In the primary DA-treated patients (n = 79), the reduction in PRL or tumor size after the first year predicted the combined response at the last follow-up (P < .001 and P = .012, respectively).
Conclusion
DAs effectively reduced PRL and tumor size, but approximately 1 patient out of 4 needed multimodal treatment. Our results suggest that the response to DA after 1 year is useful for identifying patients who need more careful monitoring and, in some cases, additional treatment. | |
dc.language | EN | |
dc.rights | Attribution 4.0 International | |
dc.rights.uri | https://creativecommons.org/licenses/by/4.0/ | |
dc.title | Long-term Follow-up of 84 Patients With Giant Prolactinomas-A Swedish Nationwide Study | |
dc.title.alternative | ENEngelskEnglishLong-term Follow-up of 84 Patients With Giant Prolactinomas-A Swedish Nationwide Study | |
dc.type | Journal article | |
dc.creator.author | Himonakos, Christos | |
dc.creator.author | Burman, Pia | |
dc.creator.author | Borg, Henrik | |
dc.creator.author | Dahlqvist, Per | |
dc.creator.author | Engström, Britt Edén | |
dc.creator.author | Ekman, Bertil | |
dc.creator.author | Emilsson, Louise | |
dc.creator.author | Olsson, Daniel S. | |
dc.creator.author | Ragnarsson, Oskar | |
dc.creator.author | Wahlberg, Jeanette | |
dc.creator.author | Åkerman, Anna-Karin | |
dc.creator.author | Höybye, Charlotte | |
dc.creator.author | Berinder, Katarina | |
cristin.unitcode | 185,52,15,0 | |
cristin.unitname | Avdeling for allmennmedisin | |
cristin.ispublished | true | |
cristin.fulltext | original | |
cristin.qualitycode | 2 | |
dc.identifier.cristin | 2216458 | |
dc.identifier.bibliographiccitation | info:ofi/fmt:kev:mtx:ctx&ctx_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.jtitle=Journal of Clinical Endocrinology and Metabolism (JCEM)&rft.volume=108&rft.spage=e1506&rft.date=2023 | |
dc.identifier.jtitle | Journal of Clinical Endocrinology and Metabolism (JCEM) | |
dc.identifier.volume | 108 | |
dc.identifier.issue | 12 | |
dc.identifier.startpage | e1506 | |
dc.identifier.endpage | e1514 | |
dc.identifier.doi | https://doi.org/10.1210/clinem/dgad393 | |
dc.type.document | Tidsskriftartikkel | |
dc.type.peerreviewed | Peer reviewed | |
dc.source.issn | 0021-972X | |
dc.type.version | PublishedVersion | |