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  1. Article: Pre-operative dopamine agonist therapy improves post-operative tumor control following prolactinoma resection

    Sughrue, Michael E / Chang, Edward F / Tyrell, J. Blake / Kunwar, Sandeep / Wilson, Charles B / Blevins, Lewis S. Jr

    Pituitary. 2009 Sept., v. 12, no. 3

    2009  

    Abstract: Objective Normalization of serum prolactin concentrations in patients with prolactinomas is an accepted endpoint of therapy. Clinical signs and symptoms of hyperprolactinemia are usually resolved when prolactin levels are lowered to within the normal ... ...

    Abstract Objective Normalization of serum prolactin concentrations in patients with prolactinomas is an accepted endpoint of therapy. Clinical signs and symptoms of hyperprolactinemia are usually resolved when prolactin levels are lowered to within the normal range. While most patients are treated with dopamine agonist drugs, some patients require surgical resection of their tumors. We sought to determine whether preoperative treatment with dopamine agonists alters the outcome of surgical intervention. Methods and results We present an analysis of 253 patients with prolactinomas treated surgically during the period of time when dopamine agonist therapy was first introduced and prior to its widespread use as first-line therapy. We compared both short- and long-term outcomes of patients treated with dopamine agonists prior to surgery with those undergoing surgery as their initial treatment modality. Our data showed that that patients treated with dopamine agonists prior to surgery experienced greater reductions in prolactin levels, had lower prolactin levels, were more likely to have normal prolactin levels at long term follow-up, and were less likely to require additional therapy to control their prolactin levels. Conclusion Our study provides strong evidence suggesting that, regardless of initial prolactin level, preoperative dopamine agonist therapy is not detrimental. In fact, pretreatment with dopamine agonist drugs, possibly by inducing tumor regression, seemed to improve the surgeon's ability to resect a greater percentage of the tumor and led to better control of the prolactin level.
    Language English
    Dates of publication 2009-09
    Size p. 158-164.
    Publisher Springer US
    Publishing place Boston
    Document type Article
    ZDB-ID 1385151-2
    ISSN 1573-7403 ; 1386-341X
    ISSN (online) 1573-7403
    ISSN 1386-341X
    DOI 10.1007/s11102-008-0135-1
    Database NAL-Catalogue (AGRICOLA)

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    In stock of ZB MED Cologne/Königswinter

    Zs.A 6139: Show issues Location:
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  2. Article ; Online: Differences Between Bilateral Adrenal Incidentalomas and Unilateral Lesions.

    Pasternak, Jesse D / Seib, Carolyn D / Seiser, Natalie / Tyrell, J Blake / Liu, Chienying / Cisco, Robin M / Gosnell, Jessica E / Shen, Wen T / Suh, Insoo / Duh, Quan-Yang

    JAMA surgery

    2015  Volume 150, Issue 10, Page(s) 974–978

    Abstract: Importance: Adrenal incidentalomas are found in 1% to 5% of abdominal cross-sectional imaging studies. Although the workup and management of unilateral lesions are well established, limited information exists for bilateral incidentalomas.: Objective: ...

    Abstract Importance: Adrenal incidentalomas are found in 1% to 5% of abdominal cross-sectional imaging studies. Although the workup and management of unilateral lesions are well established, limited information exists for bilateral incidentalomas.
    Objective: To compare the natural history of patients having bilateral incidentalomas with those having unilateral incidentalomas.
    Design, setting, and participants: Retrospective analysis of a prospective database of consecutive patients referred to an academic multidisciplinary adrenal conference. The setting was a tertiary care university hospital among a cohort of 500 patients with adrenal lesions between July 1, 2009, and July 1, 2014.
    Main outcomes and measures: Prevalence, age, imaging characteristics, biochemical workup, any intervention, and final diagnosis.
    Results: Twenty-three patients with bilateral incidentalomas and 112 patients with unilateral incidentalomas were identified. The mean age at diagnosis of bilateral lesions was 58.7 years. The mean lesion size was 2.4 cm on the right side and 2.8 cm on the left side. Bilateral incidentalomas were associated with a significantly higher prevalence of subclinical Cushing syndrome (21.7% [5 of 23] vs 6.2% [7 of 112]) (P = .009) and a significantly lower prevalence of pheochromocytoma (4.3% [1 of 23] vs 19.6% [22 of 112]) (P = .003) compared with unilateral lesions, while rates of hyperaldosteronism were similar in both groups (4.3% [1 of 23] vs 5.4% [6 of 112]) (P > .99). Only one patient with bilateral incidentalomas underwent unilateral resection. The mean follow-up was 4 years (range, 1.2-13.0 years). There were no occult adrenocortical carcinomas.
    Conclusions and relevance: Bilateral incidentalomas are more likely to be associated with subclinical Cushing syndrome and less likely to be pheochromocytomas. Although patients with bilateral incidentalomas undergo a workup similar to that in patients with unilateral lesions, differences in their natural history warrant a greater index of suspicion for subclinical Cushing syndrome.
    MeSH term(s) Adrenal Gland Neoplasms/diagnosis ; Cushing Syndrome/diagnosis ; Female ; Humans ; Incidental Findings ; Male ; Middle Aged ; Pheochromocytoma/diagnosis ; Retrospective Studies
    Language English
    Publishing date 2015-10
    Publishing country United States
    Document type Comparative Study ; Journal Article
    ZDB-ID 2701841-6
    ISSN 2168-6262 ; 2168-6254
    ISSN (online) 2168-6262
    ISSN 2168-6254
    DOI 10.1001/jamasurg.2015.1683
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Uk I Zs.72: Show issues Location:
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  3. Article ; Online: Pre-operative dopamine agonist therapy improves post-operative tumor control following prolactinoma resection.

    Sughrue, Michael E / Chang, Edward F / Tyrell, J Blake / Kunwar, Sandeep / Wilson, Charles B / Blevins, Lewis S

    Pituitary

    2008  Volume 12, Issue 3, Page(s) 158–164

    Abstract: Objective: Normalization of serum prolactin concentrations in patients with prolactinomas is an accepted endpoint of therapy. Clinical signs and symptoms of hyperprolactinemia are usually resolved when prolactin levels are lowered to within the normal ... ...

    Abstract Objective: Normalization of serum prolactin concentrations in patients with prolactinomas is an accepted endpoint of therapy. Clinical signs and symptoms of hyperprolactinemia are usually resolved when prolactin levels are lowered to within the normal range. While most patients are treated with dopamine agonist drugs, some patients require surgical resection of their tumors. We sought to determine whether preoperative treatment with dopamine agonists alters the outcome of surgical intervention.
    Methods and results: We present an analysis of 253 patients with prolactinomas treated surgically during the period of time when dopamine agonist therapy was first introduced and prior to its widespread use as first-line therapy. We compared both short- and long-term outcomes of patients treated with dopamine agonists prior to surgery with those undergoing surgery as their initial treatment modality. Our data showed that that patients treated with dopamine agonists prior to surgery experienced greater reductions in prolactin levels, had lower prolactin levels, were more likely to have normal prolactin levels at long term follow-up, and were less likely to require additional therapy to control their prolactin levels.
    Conclusion: Our study provides strong evidence suggesting that, regardless of initial prolactin level, preoperative dopamine agonist therapy is not detrimental. In fact, pretreatment with dopamine agonist drugs, possibly by inducing tumor regression, seemed to improve the surgeon's ability to resect a greater percentage of the tumor and led to better control of the prolactin level.
    MeSH term(s) Adult ; Bromocriptine/therapeutic use ; Dopamine Agonists/therapeutic use ; Female ; Humans ; Male ; Postoperative Period ; Preoperative Care ; Prolactin/blood ; Prolactinoma/blood ; Prolactinoma/drug therapy ; Prolactinoma/surgery ; Treatment Outcome
    Chemical Substances Dopamine Agonists ; Bromocriptine (3A64E3G5ZO) ; Prolactin (9002-62-4)
    Language English
    Publishing date 2008-07-24
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1385151-2
    ISSN 1573-7403 ; 1386-341X
    ISSN (online) 1573-7403
    ISSN 1386-341X
    DOI 10.1007/s11102-008-0135-1
    Database MEDical Literature Analysis and Retrieval System OnLINE

    Full text online

    More links

    Kategorien

    In stock of ZB MED Cologne/Königswinter

    Zs.A 6139: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
    ab Jg. 2022: Lesesaal (EG)

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

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