Akademik Veri Yönetim Sistemi
EANS 2025, Vienna, Avusturya, 5 - 09 Ekim 2025, ss.19, (Özet Bildiri)
Prolactinomas,are treated medically or surgically.While dopamine agonists (DAs) are first-line therapy,the endoscopic endonasal approach(EEA) offers low morbidity and shorter hospital stays.This study examines EEA outcomes and factors affecting remission and recurrence. Methods MethodsA retrospective analysis was conducted on 201 consecutive patients diagnosed with prolactinomas who underwent EEA between January 2014 and January 2024.All surgeries were performed at a single tertiary center,with patients followed for a mean duration of 44.19 ± 25.81 months(range: 18–121 months). Results The mean tumor volume was 24.61± 13.97 (5-66)mm and gross total resection (GTR) was noted in 140/201(69.7%)patients. 41/201(20.4%)of patients had operation history.A history of preoperative medical treatment was present in 162/201(80.6%) patients. Early disease remission was correlated with female gender (p=0.039) and absence of preoperative prolactin level>200 μg/L (p<0.001) according to multivariate analysis.Persistent disease was reported in 89/201(44.3%) of patients, with 44.9% of them achieved remission at last follow-up with DA therapy alone.Repeat EEA was utilized in 10 patients, with 70% achieving remission.Last follow-up remission was achieved in 112/201 (55.7%) patients, with symptomatic improvement in 136/201 (67.7%).Factors predicting last follow-up remission were female sex (p=0.011),absence of preoperative prolactin level>200 μg/L (p=0.022),and absence of firm-fibrotic tumor nature (p<0.001) according to logistic regression analysis.Recurrence occurred in 44/201(21.9%) patients,with early recurrence in 20/44 cases and late recurrence in 24/44 cases.Disease control was achieved with medical treatment after recurrence in 6/44 patients,while 20/44 patients did not benefit from medical therapy. Conclusions EEA effectively controls prolactinomas by significantly reducing tumor volume. Identifying predictors of remission and recurrence is crucial for EEA’s role as an alternative to medical management.