Introduction: This guideline (GL) is aimed at providing a reference for the management of prolactin (PRL)-secreting pituitary adenoma in adults. However, pregnancy is not considered.

Methods: This GL has been developed following the methods described in the Manual of the Italian National Guideline System. For each question, the panel appointed by Associazione Medici Endocrinologi (AME) has identified potentially relevant outcomes, which have then been rated for their impact on therapeutic choices. Only outcomes classified as “critical” and “important” have been considered in the systematic review of evidence and only those classified as “critical” have been considered in the formulation of recommendations.

Results: The present GL provides recommendations regarding the role of pharmacological and neurosurgical treatment in the management of prolactinomas. We recommend cabergoline (Cab) vs. bromocriptine (Br) as the firstchoice pharmacological treatment to be employed at the minimal effective dose capable of achieving the regression of the clinical picture. We suggest that medication and surgery are offered as suitable alternative first-line treatments to patients with non-invasive PRL-secreting adenoma, regardless of size. We suggest Br as an alternative drug in patients who are intolerant to Cab and are not candidates for surgery. We recommend pituitary tumor resection in patients 1) without any significant neuro-ophthalmologic improvement within two weeks from the start of Cab, 2) who are resistant or do not tolerate Cab or other dopamine-agonist drugs (DA), 3) who escape from previous efficacy of DA, and 4) who are unwilling to undergo a chronic DA treatment. We recommend that patients with progressive disease notwithstanding previous tumor resection and ongoing DA should be managed by a multidisciplinary team with specific expertise in pituitary diseases using a multimodal approach that includes repeated surgery, radiotherapy, DA, and possibly, the use of temozolomide.

Conclusion: The present GL is directed to endocrinologists, neurosurgeons, and gynecologists working in hospitals, in territorial services or private practice, and to general practitioners and patients.

Keywords: Prolactinoma, prolactin-secreting tumor, microprolactinoma, macroprolactinoma, cost-efficacy analysis, cabergoline, bromocriptine, neurosurgery, radiotherapy, temozolomide.

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Chanson, P.; Maiter, D. The epidemiology, diagnosis and treatment of Prolactinomas: The old and the new. Best Pract. Res. Clin. Endocrinol. Metab., 2019, 33(2), 101290.
[http://dx.doi.org/10.1016/j.beem.2019.101290] [PMID: 31326373]
Vroonen, L.; Daly, A.F.; Beckers, A. Epidemiology and management challenges in prolactinomas. Neuroendocrinology, 2019, 109(1), 20-27.
[http://dx.doi.org/10.1159/000497746] [PMID: 30731464]
Olarescu, N.C.; Perez-Rivas, L.G.; Gatto, F.; Cuny, T.; Tichomirowa, M.A.; Tamagno, G.; Gahete, M.D. Aggressive and malignant prolactinomas. Neuroendocrinology, 2019, 109(1), 57-69.
[http://dx.doi.org/10.1159/000497205] [PMID: 30677777]
de Laat, J.M.; Dekkers, O.M.; Pieterman, C.R.C.; Kluijfhout, W.P.; Hermus, A.R.; Pereira, A.M.; van der Horst-Schrivers, A.N.; Drent, M.L.; Bisschop, P.H.; Havekes, B.; de Herder, W.W.; Valk, G.D. Long-term natural course of pituitary tumors in patients with MEN1: Results from the Dutch MEN1 study group (DMSG). J. Clin. Endocrinol. Metab., 2015, 100(9), 3288-3296.
[http://dx.doi.org/10.1210/JC.2015-2015] [PMID: 26126205]
Daly, A.F.; Tichomirowa, M.A.; Petrossians, P.; Heliövaara, E.; Jaffrain-Rea, M.L.; Barlier, A.; Naves, L.A.; Ebeling, T.; Karhu, A.; Raappana, A.; Cazabat, L.; De Menis, E.; Montañana, C.F.; Raverot, G.; Weil, R.J.; Sane, T.; Maiter, D.; Neggers, S.; Yaneva, M.; Tabarin, A.; Verrua, E.; Eloranta, E.; Murat, A.; Vierimaa, O.; Salmela, P.I.; Emy, P.; Toledo, R.A.; Sabaté, M.I.; Villa, C.; Popelier, M.; Salvatori, R.; Jennings, J.; Longás, Á.F.; Labarta Aizpún, J.I.; Georgitsi, M.; Paschke, R.; Ronchi, C.; Valimaki, M.; Saloranta, C.; De Herder, W.; Cozzi, R.; Guitelman, M.; Magri, F.; Lagonigro, M.S.; Halaby, G.; Corman, V.; Hagelstein, M.T.; Vanbellinghen, J.F.; Barra, G.B.; Gimenez-Roqueplo, A.P.; Cameron, F.J.; Borson-Chazot, F.; Holdaway, I.; Toledo, S.P.A.; Stalla, G.K.; Spada, A.; Zacharieva, S.; Bertherat, J.; Brue, T.; Bours, V.; Chanson, P.; Aaltonen, L.A.; Beckers, A. Clinical characteristics and therapeutic responses in patients with germ-line AIP mutations and pituitary adenomas: An international collaborative study. J. Clin. Endocrinol. Metab., 2010, 95(11), E373-E383.
[http://dx.doi.org/10.1210/jc.2009-2556] [PMID: 20685857]
Soto-Pedre, E.; Newey, P.J.; Bevan, J.S.; Leese, G.P. Morbidity and mortality in patients with hyperprolactinaemia: The PROLEARS study. Endocr. Connect., 2017, 6(8), 580-588.
[http://dx.doi.org/10.1530/EC-17-0171] [PMID: 28954743]
Melmed, S.; Casanueva, F.F.; Hoffman, A.R.; Kleinberg, D.L.; Montori, V.M.; Schlechte, J.A.; Wass, J.A.H. Diagnosis and treatment of hyperprolactinemia: An Endocrine Society clinical practice guideline. J. Clin. Endocrinol. Metab., 2011, 96(2), 273-288.
[http://dx.doi.org/10.1210/jc.2010-1692] [PMID: 21296991]
De Rosa, M.; Zarrilli, S.; Di Sarno, A.; Milano, N.; Gaccione, M.; Boggia, B.; Lombardi, G.; Colao, A. Hyperprolactinemia in men: Clinical and biochemical features and response to treatment. Endocr. J., 2003, 20(1-2), 75-82.
[http://dx.doi.org/10.1385/ENDO:20:1-2:75] [PMID: 12668871]
Samperi, I.; Lithgow, K.; Karavitaki, N. Hyperprolactinaemia. J. Clin. Med., 2019, 8(12), 2203.
[http://dx.doi.org/10.3390/jcm8122203] [PMID: 31847209]
Hayashi, Y.; Sasagawa, Y.; Oishi, M.; Kita, D.; Misaki, K.; Fukui, I.; Tachibana, O.; Nakada, M. Contribution of intrasellar pressure elevation to headache manifestation in pituitary adenoma evaluated with intraoperative pressure measurement. Neurosurgery, 2019, 84(3), 599-606.
[http://dx.doi.org/10.1093/neuros/nyy087] [PMID: 29618106]
Bussone, G.; Usai, S.; Moschiano, F. How to investigate and treat: Headache and hyperprolactinemia. Curr. Pain Headache Rep., 2012, 16(4), 365-370.
[http://dx.doi.org/10.1007/s11916-012-0267-x] [PMID: 22639180]
Kallestrup, M.M.; Kasch, H.; Østerby, T.; Nielsen, E.; Jensen, T.S.; Jørgensen, J.O.L. Prolactinoma-associated headache and dopamine agonist treatment. Cephalalgia, 2014, 34(7), 493-502.
[http://dx.doi.org/10.1177/0333102413515343] [PMID: 24351278]
Česák, T.; Poczos, P.; Adamkov, J.; Náhlovský, J.; Kašparová, P.; Gabalec, F.; Čelakovský, P.; Choutka, O. Medically induced CSF rhinorrhea following treatment of macroprolactinoma: Case series and literature review. Pituitary, 2018, 21(6), 561-570.
[http://dx.doi.org/10.1007/s11102-018-0907-1] [PMID: 30116971]
di Filippo, L.; Doga, M.; Resmini, E.; Giustina, A. Hyperprolactinemia and bone. Pituitary, 2020, 23(3), 314-321.
[http://dx.doi.org/10.1007/s11102-020-01041-3] [PMID: 32219718]
Mazziotti, G.; Mancini, T.; Mormando, M.; De Menis, E.; Bianchi, A.; Doga, M.; Porcelli, T.; Vescovi, P.P.; De Marinis, L.; Giustina, A. High prevalence of radiological vertebral fractures in women with prolactin-secreting pituitary adenomas. Pituitary, 2011, 14(4), 299-306.
[http://dx.doi.org/10.1007/s11102-011-0293-4] [PMID: 21301967]
Klibanski, A.; Greenspan, S.L. Increase in bone mass after treatment of hyperprolactinemic amenorrhea. N. Engl. J. Med., 1986, 315(9), 542-546.
[http://dx.doi.org/10.1056/NEJM198608283150903] [PMID: 3736637]
Vilar, L.; Vilar, C.F.; Lyra, R.; Freitas, M.C. Pitfalls in the diagnostic evaluation of hyperprolactinemia. Neuroendocrinology, 2019, 109(1), 7-19.
[http://dx.doi.org/10.1159/000499694] [PMID: 30889571]
Tsur, A.; Dreyfuss, E.; Ness-Abramof, R.; Pollack, R.; Cahn, A. Role of cannulated prolactin test in evaluation of hyperprolactinemia - A retrospective study. Endocr. Pract., 2020, 26(11), 1304-1311.
[http://dx.doi.org/10.4158/EP-2020-0260] [PMID: 33471661]
Sturk, A.; Sanders, G.T. Macro enzymes: Prevalence, composition, detection and clinical relevance. J. Clin. Chem. Clin. Biochem., 1990, 28(2), 65-81.
[PMID: 2184194]
Vilar, L.; Abucham, J.; Albuquerque, J.L.; Araujo, L.A.; Azevedo, M.F.; Boguszewski, C.L.; Casulari, L.A.; Cunha, M.B.C.; Czepielewski, M.A.; Duarte, F.H.G.; Faria, M.S.; Gadelha, M.R.; Garmes, H.M.; Glezer, A.; Gurgel, M.H.; Jallad, R.S.; Martins, M.; Miranda, P.A.C.; Montenegro, R.M.; Musolino, N.R.C.; Naves, L.A.; Ribeiro-Oliveira, A.; Silva, C.M.S.; Viecceli, C.; Bronstein, M.D. Controversial issues in the management of hyperprolactinemia and prolactinomas – An overview by the Neuroendocrinology Department of the Brazilian Society of Endocrinology and Metabolism. Arch. Endocrinol. Metab., 2018, 62(2), 236-263.
[http://dx.doi.org/10.20945/2359-3997000000032] [PMID: 29768629]
Gibney, J.; Smith, T.P.; McKenna, T.J. Clinical relevance of macroprolactin. Clin. Endocrinol., 2005, 62(6), 633-643.
[http://dx.doi.org/10.1111/j.1365-2265.2005.02243.x] [PMID: 15943822]
Fleseriu, M.; Lee, M.; Pineyro, M.M.; Skugor, M.; Reddy, S.K.; Siraj, E.S.; Hamrahian, A.H. Giant invasive pituitary prolactinoma with falsely low serum prolactin: the significance of ‘hook effect’. J. Neurooncol., 2006, 79(1), 41-43.
[http://dx.doi.org/10.1007/s11060-005-9108-7] [PMID: 16598425]
Piketty, M.L.; Prie, D.; Sedel, F.; Bernard, D.; Hercend, C.; Chanson, P.; Souberbielle, J.C. High-dose biotin therapy leading to false biochemical endocrine profiles: validation of a simple method to overcome biotin interference. Clin. Chem. Lab. Med. (CCLM), 2017, 55(6), 817-825.
[http://dx.doi.org/10.1515/cclm-2016-1183] [PMID: 28222020]
Aliberti, L.; Gagliardi, I.; Dorizzi, R.M.; Pizzicotti, S.; Bondanelli, M.; Zatelli, M.C.; Ambrosio, M.R. Hypeprolactinemia: Still an insidious diagnosis. Endocrine, 2021, 72(3), 928-931.
[http://dx.doi.org/10.1007/s12020-020-02497-w] [PMID: 32949349]
Khawaja, N.M.; Taker, B.M.; Barham, M.E.; Naser, A.A.; Hadidy, A.M.; Ahmad, A.T.; Hamamy, H.A.; Yaghi, N.A.; Ajlouni, K.M. Pituitary enlargement in patients with primary hypothyroidism. Endocr. Pract., 2006, 12(1), 29-34.
[http://dx.doi.org/10.4158/EP.12.1.29] [PMID: 16524860]
Peuskens, J.; Pani, L.; Detraux, J.; De Hert, M. The effects of novel and newly approved antipsychotics on serum prolactin levels: A comprehensive review. CNS Drugs, 2014, 28(5), 421-453.
[http://dx.doi.org/10.1007/s40263-014-0157-3] [PMID: 24677189]
Molitch, M.E. Dopamine agonists and antipsychotics. Eur. J. Endocrinol., 2020, 183(3), C11-C13.
[http://dx.doi.org/10.1530/EJE-20-0607] [PMID: 32508315]
Alvarez-Tutor, E. Forga-LLenas, L.; Rodriguez-Erdozain, R.; Goñi-Iriarte, M.J.; Menendez-Torre, E.; Alvarez-Tutor, J. Persistent increase of PRL after oral contraceptive treatment. Arch. Gynecol. Obstet., 1999, 263(1-2), 45-50.
[http://dx.doi.org/10.1007/s004040050261] [PMID: 10728629]
Burlacu, M.C.; Maiter, D.; Duprez, T.; Delgrange, E. T2-weighted magnetic resonance imaging characterization of prolactinomas and association with their response to dopamine agonists. Endocrine, 2019, 63(2), 323-331.
[http://dx.doi.org/10.1007/s12020-018-1765-3] [PMID: 30267354]
Tosaka, M.; Sato, N.; Hirato, J.; Fujimaki, H.; Yamaguchi, R.; Kohga, H.; Hashimoto, K.; Yamada, M.; Mori, M.; Saito, N.; Yoshimoto, Y. Assessment of hemorrhage in pituitary macroadenoma by T2*-weighted gradient-echo MR imaging. AJNR Am. J. Neuroradiol., 2007, 28(10), 2023-2029.
[http://dx.doi.org/10.3174/ajnr.A0692] [PMID: 17898201]
Verhelst, J.; Abs, R.; Maiter, D.; van den Bruel, A.; Vandeweghe, M.; Velkeniers, B.; Mockel, J.; Lamberigts, G.; Petrossians, P.; Coremans, P.; Mahler, C.; Stevenaert, A.; Verlooy, J.; Raftopoulos, C.; Beckers, A. Cabergoline in the treatment of hyperprolactinemia: A study in 455 patients. J. Clin. Endocrinol. Metab., 1999, 84(7), 2518-2522.
[http://dx.doi.org/10.1210/jcem.84.7.5810] [PMID: 10404830]
Colao, A.; Di Sarno, A.; Landi, M.L.; Scavuzzo, F.; Cappabianca, P.; Pivonello, R.; Volpe, R.; Di Salle, F.; Cirillo, S.; Annunziato, L.; Lombardi, G. Macroprolactinoma shrinkage during cabergoline treatment is greater in naive patients than in patients pretreated with other dopamine agonists: A prospective study in 110 patients. J. Clin. Endocrinol. Metab., 2000, 85(6), 2247-2252.
[http://dx.doi.org/10.1210/jc.85.6.2247] [PMID: 10852458]
Casanueva, F.F.; Molitch, M.E.; Schlechte, J.A.; Abs, R.; Bonert, V.; Bronstein, M.D.; Brue, T.; Cappabianca, P.; Colao, A.; Fahlbusch, R.; Fideleff, H.; Hadani, M.; Kelly, P.; Kleinberg, D.; Laws, E.; Marek, J.; Scanlon, M.; Sobrinho, L.G.; Wass, J.A.H.; Giustina, A. Guidelines of the Pituitary Society for the diagnosis and management of prolactinomas. Clin. Endocrinol., 2006, 65(2), 265-273.
[http://dx.doi.org/10.1111/j.1365-2265.2006.02562.x] [PMID: 16886971]
Cozzi, R.; Ambrosio, M.R.; Attanasio, R.; Battista, C.; Bozzao, A.; Caputo, M.; Ciccarelli, E.; De Marinis, L.; De Menis, E.; Faustini, F.M.; Grimaldi, F.; Lania, A.; Lasio, G.; Logoluso, F.; Losa, M.; Maffei, P.; Milani, D.; Poggi, M.; Zini, M.; Katznelson, L.; Luger, A.; Poiana, C. Italian Association of clinical endocrinologists (AME) and International Chapter of Clinical Endocrinology (ICCE). Position statement for clinical practice: Prolactin-secreting tumors. Eur. J. Endocrinol., 2022, 186(3), 1-P33.
[http://dx.doi.org/10.1530/EJE-21-0977] [PMID: 35000899]
Del Dotto, P.; Bonuccelli, U. Clinical pharmacokinetics of cabergoline. Clin. Pharmacokinet., 2003, 42(7), 633-645.
[http://dx.doi.org/10.2165/00003088-200342070-00003] [PMID: 12844325]
Vroonen, L.; Jaffrain-Rea, M.L.; Petrossians, P.; Tamagno, G.; Chanson, P.; Vilar, L.; Borson-Chazot, F.; Naves, L.A.; Brue, T.; Gatta, B.; Delemer, B.; Ciccarelli, E.; Beck-Peccoz, P.; Caron, P.; Daly, A.F.; Beckers, A. Prolactinomas resistant to standard doses of cabergoline: A multicenter study of 92 patients. Eur. J. Endocrinol., 2012, 167(5), 651-662.
[http://dx.doi.org/10.1530/EJE-12-0236] [PMID: 22918301]
Ciccarelli, E.; Camanni, F. Diagnosis and drug therapy of prolactinoma. Drugs, 1996, 51(6), 954-965.
[http://dx.doi.org/10.2165/00003495-199651060-00004] [PMID: 8736617]
Bancos, I.; Nannenga, M.R.; Bostwick, J.M.; Silber, M.H.; Erickson, D.; Nippoldt, T.B. Impulse control disorders in patients with dopamine agonist-treated prolactinomas and nonfunctioning pituitary adenomas: A case-control study. Clin. Endocrinol., 2014, 80(6), 863-868.
[http://dx.doi.org/10.1111/cen.12375] [PMID: 24274365]
De Sousa, S.M.C.; Chapman, I.M.; Falhammar, H.; Torpy, D.J. Dopa-testotoxicosis: Disruptive hypersexuality in hypogonadal men with prolactinomas treated with dopamine agonists. Endocrine, 2017, 55(2), 618-624.
[http://dx.doi.org/10.1007/s12020-016-1088-1] [PMID: 27601019]
Stiles, C.E.; Tetteh-Wayoe, E.T.; Bestwick, J.; Steeds, R.P.; Drake, W.M. A meta-analysis of the prevalence of cardiac valvulopathy in hyperprolactinemic patients treated with Cabergoline. J. Clin. Endocrinol. Metab., 2018, 104, 523-538.
[http://dx.doi.org/10.1210/jc.2018-01071] [PMID: 30215804]
Steeds, R.; Stiles, C.; Sharma, V.; Chambers, J.; Lloyd, G.; Drake, W. Echocardiography and monitoring patients receiving dopamine agonist therapy for hyperprolactinaemia: A joint position statement of the British Society of Echocardiography, the British Heart Valve Society and the Society for Endocrinology. Clin. Endocrinol., 2019, 90(5), 662-669.
[http://dx.doi.org/10.1111/cen.13940] [PMID: 30818417]
Schlechte, J.; Dolan, K.; Sherman, B.; Chapler, F.; Luciano, A. The natural history of untreated hyperprolactinemia: A prospective analysis. J. Clin. Endocrinol. Metab., 1989, 68(2), 412-418.
[http://dx.doi.org/10.1210/jcem-68-2-412] [PMID: 2918052]
Delgrange, E.; Daems, T.; Verhelst, J.; Abs, R.; Maiter, D. Characterization of resistance to the prolactin-lowering effects of cabergoline in macroprolactinomas: A study in 122 patients. Eur. J. Endocrinol., 2009, 160(5), 747-752.
[http://dx.doi.org/10.1530/EJE-09-0012] [PMID: 19223454]
Molitch, M.E. Dopamine resistance of prolactinomas. Pituitary, 2003, 6(1), 19-27.
[http://dx.doi.org/10.1023/A:1026225625897] [PMID: 14674720]
Souteiro, P.; Karavitaki, N. Dopamine agonist resistant prolactinomas: Any alternative medical treatment? Pituitary, 2020, 23(1), 27-37.
[http://dx.doi.org/10.1007/s11102-019-00987-3] [PMID: 31522358]
Maiter, D. Management of dopamine agonist-resistant prolactinoma. Neuroendocrinology, 2019, 109(1), 42-50.
[http://dx.doi.org/10.1159/000495775] [PMID: 30481756]
Araújo, C.; Marques, O.; Almeida, R.; Santos, M.J. Macroprolactinomas: Longitudinal assessment of biochemical and imaging therapeutic responses. Endocrine, 2018, 62(2), 470-476.
[http://dx.doi.org/10.1007/s12020-018-1703-4] [PMID: 30088141]
Vermeulen, E.; D’Haens, J.; Stadnik, T.; Unuane, D.; Barbe, K.; Van Velthoven, V.; Gläsker, S. Predictors of dopamine agonist resistance in prolactinoma patients. BMC Endocr. Disord., 2020, 20(1), 68.
[http://dx.doi.org/10.1186/s12902-020-0543-4] [PMID: 32429916]
Colao, A.; Di Sarno, A.; Cappabianca, P.; Di Somma, C.; Pivonello, R.; Lombardi, G. Withdrawal of long-term cabergoline therapy for tumoral and nontumoral hyperprolactinemia. N. Engl. J. Med., 2003, 349(21), 2023-2033.
[http://dx.doi.org/10.1056/NEJMoa022657] [PMID: 14627787]
Bonert, V. Do nothing but observe microprolactinomas: When and how to replace sex hormones? Pituitary, 2020, 23(3), 307-313.
[http://dx.doi.org/10.1007/s11102-020-01039-x] [PMID: 32274622]
Cocks Eschler, D.; Javanmard, P.; Cox, K.; Geer, E.B. Prolactinoma through the female life cycle. Endocrine, 2018, 59(1), 16-29.
[http://dx.doi.org/10.1007/s12020-017-1438-7] [PMID: 29177641]
Colao, A.; Vitale, G.; Cappabianca, P.; Briganti, F.; Ciccarelli, A.; De Rosa, M.; Zarrilli, S.; Lombardi, G. Outcome of cabergoline treatment in men with prolactinoma: Effects of a 24-month treatment on prolactin levels, tumor mass, recovery of pituitary function, and semen analysis. J. Clin. Endocrinol. Metab., 2004, 89(4), 1704-1711.
[http://dx.doi.org/10.1210/jc.2003-030979] [PMID: 15070934]
Christin-Maître, S.; Delemer, B.; Touraine, P.; Young, J. Prolactinoma and estrogens: Pregnancy, contraception and hormonal replacement therapy. Ann. Endocrinol., 2007, 68(2-3), 106-112.
[http://dx.doi.org/10.1016/j.ando.2007.03.008] [PMID: 17540335]
Duskin-Bitan, H.; Shimon, I. Prolactinomas in males: Any differences? Pituitary, 2020, 23(1), 52-57.
[http://dx.doi.org/10.1007/s11102-019-01009-y] [PMID: 31802331]
Honegger, J.; Nasi-Kordhishti, I.; Aboutaha, N.; Giese, S. Surgery for prolactinomas: A better choice? Pituitary, 2020, 23(1), 45-51.
[http://dx.doi.org/10.1007/s11102-019-01016-z] [PMID: 31853793]
Zamanipoor, N.A.H.; Zandbergen, I.M.; de Vries, F.; Broersen, L.H.A.; van den Akker-van Marle, M.E.; Pereira, A.M.; Peul, W.C.; Dekkers, O.M.; van Furth, W.R.; Biermasz, N.R. Surgery as a viable alternative first-line treatment for prolactinoma patients. A systematic review and meta-analysis. J. Clin. Endocrinol. Metab., 2020, 105(3), e32-e41.
[http://dx.doi.org/10.1210/clinem/dgz144] [PMID: 31665485]
Tampourlou, M.; Trifanescu, R.; Paluzzi, A.; Ahmed, S.K.; Karavitaki, N. Therapy of endocrine disease: Surgery in microprolactinomas: Effectiveness and risks based on contemporary literature. Eur. J. Endocrinol., 2016, 175(3), R89-R96.
[http://dx.doi.org/10.1530/EJE-16-0087] [PMID: 27207245]
Ikeda, H.; Watanabe, K.; Tominaga, T.; Yoshimoto, T. Transsphenoidal microsurgical results of female patients with prolactinomas. Clin. Neurol. Neurosurg., 2013, 115(9), 1621-1625.
[http://dx.doi.org/10.1016/j.clineuro.2013.02.016] [PMID: 23498159]
Primeau, V.; Raftopoulos, C.; Maiter, D. Outcomes of transsphenoidal surgery in prolactinomas: improvement of hormonal control in dopamine agonist-resistant patients. Eur. J. Endocrinol., 2012, 166(5), 779-786.
[http://dx.doi.org/10.1530/EJE-11-1000] [PMID: 22301915]
Raverot, G.; Wierinckx, A.; Dantony, E.; Auger, C.; Chapas, G.; Villeneuve, L.; Brue, T.; Figarella-Branger, D.; Roy, P.; Jouanneau, E.; Jan, M.; Lachuer, J.; Trouillas, J. Prognostic factors in prolactin pituitary tumors: Clinical, histological, and molecular data from a series of 94 patients with a long postoperative follow-up. J. Clin. Endocrinol. Metab., 2010, 95(4), 1708-1716.
[http://dx.doi.org/10.1210/jc.2009-1191] [PMID: 20164287]
Kreutzer, J.; Buslei, R.; Wallaschofski, H.; Hofmann, B.; Nimsky, C.; Fahlbusch, R.; Buchfelder, M. Operative treatment of prolactinomas: Indications and results in a current consecutive series of 212 patients. Eur. J. Endocrinol., 2008, 158(1), 11-18.
[http://dx.doi.org/10.1530/EJE-07-0248] [PMID: 18166812]
Fatemi, N.; Dusick, J.R.; Mattozo, C.; McArthur, D.L.; Cohan, P.; Boscardin, J.; Wang, C.; Swerdloff, R.S.; Kelly, D.F. Pituitary hormonal loss and recovery after transsphenoidal adenoma removal. Neurosurgery, 2008, 63(4), 709-719.
[http://dx.doi.org/10.1227/01.NEU.0000325725.77132.90] [PMID: 18981881]
Roelfsema, F.; Biermasz, N.R.; Pereira, A.M. Clinical factors involved in the recurrence of pituitary adenomas after surgical remission: A structured review and meta-analysis. Pituitary, 2012, 15(1), 71-83.
[http://dx.doi.org/10.1007/s11102-011-0347-7] [PMID: 21918830]
Gillam, M.P.; Molitch, M.E.; Lombardi, G.; Colao, A. Advances in the treatment of prolactinomas. Endocr. Rev., 2006, 27(5), 485-534.
[http://dx.doi.org/10.1210/er.2005-9998] [PMID: 16705142]
Sheplan Olsen, L.J.; Robles Irizarry, L.; Chao, S.T.; Weil, R.J.; Hamrahian, A.H.; Hatipoglu, B.; Suh, J.H. Radiotherapy for prolactin-secreting pituitary tumors. Pituitary, 2012, 15(2), 135-145.
[http://dx.doi.org/10.1007/s11102-011-0348-6] [PMID: 21948464]
Hung, Y.C.; Lee, C.C.; Yang, H.; Mohammed, N.; Kearns, K.N.; Nabeel, A.M.; Abdel Karim, K.; Emad, E.R.M.; El-Shehaby, A.M.N.; Reda, W.A.; Tawadros, S.R.; Liscak, R.; Jezkova, J.; Lunsford, L.D.; Kano, H.; Sisterson, N.D.; Martínez, Á.R.; Martínez Moreno, N.E.; Kondziolka, D.; Golfinos, J.G.; Grills, I.; Thompson, A.; Borghei-Razavi, H.; Maiti, T.K.; Barnett, G.H.; McInerney, J.; Zacharia, B.E.; Xu, Z.; Sheehan, J.P. The benefit and risk of stereotactic radiosurgery for prolactinomas: An international multicenter cohort study. J. Neurosurg., 2020, 133(3), 717-726.
[http://dx.doi.org/10.3171/2019.4.JNS183443] [PMID: 31374549]
Fleseriu, M.; Hashim, I.A.; Karavitaki, N.; Melmed, S.; Murad, M.H.; Salvatori, R.; Samuels, M.H. Hormonal replacement in hypopituitarism in adults: An Endocrine Society clinical practice guideline. J. Clin. Endocrinol. Metab., 2016, 101(11), 3888-3921.
[http://dx.doi.org/10.1210/jc.2016-2118] [PMID: 27736313]
Trouillas, J.; Delgrange, E.; Wierinckx, A.; Vasiljevic, A.; Jouanneau, E.; Burman, P.; Raverot, G. Clinical, pathological, and molecular factors of aggressiveness in lactotroph tumours. Neuroendocrinology, 2019, 109(1), 70-76.
[http://dx.doi.org/10.1159/000499382] [PMID: 30943495]
McCormack, A.; Dekkers, O.M.; Petersenn, S.; Popovic, V.; Trouillas, J.; Raverot, G.; Burman, P. Treatment of aggressive pituitary tumours and carcinomas: Results of a European Society of Endocrinology (ESE) survey 2016. Eur. J. Endocrinol., 2018, 178(3), 265-276.
[http://dx.doi.org/10.1530/EJE-17-0933] [PMID: 29330228]
Shea, B.J.; Reeves, B.C.; Wells, G.; Thuku, M.; Hamel, C.; Moran, J.; Moher, D.; Tugwell, P.; Welch, V.; Kristjansson, E.; Henry, D.A. AMSTAR 2: A critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. BMJ, 2017, 358, j4008.
[http://dx.doi.org/10.1136/bmj.j4008] [PMID: 28935701]
Ruggeri, M.; Basile, M.; Armuzzi, A.; Cicchetti, A. Activity-based costing and budget analysis of vedolizumab versus conventional treatments in ulcerative colitis and Crohn’s disease. Glob. Reg. Health Technol. Assess., 2016, 4, e88-e99.
Rate list for specialist outpatient services. Available from: https://www.salute.gov.it/imgs/C_17_pagineAree_1767_listaFile_itemName_0_file.pdf
State General Accounting Department - Technical commission for public finance. Green Paper on Public Expenditure, 2007. Available from: http://www.astrid-online.it/static/upload/protected/Libr/Libro_ Verde_Spesa_Pubblica.pdf
Rate list for specialist services for acute patients. Available from: https://www.salute.gov.it/portale/temi/p2_6.jsp?id=3662&area=programmazioneSanitariaLea&menu=vuoto
Rossitto, C.; Gueli Alletti, S.; Romano, F.; Fiore, A.; Coretti, S.; Oradei, M.; Ruggeri, M.; Cicchetti, A.; Marchetti, M.; Fanfani, F.; Scambia, G. Use of robot-specific resources and operating room times: the case of Telelap Alf-X robotic hysterectomy. Int. J. Med. Robot., 2016, 12(4), 613-619.
[http://dx.doi.org/10.1002/rcs.1724] [PMID: 26748491]
AIFA Transparency List, Class H Drugs. Available from: https://www.aifa.gov.it/liste-farmaci-a-h
AIFA Transparency List, Class A Drugs. Available from: https://www.aifa.gov.it/liste-farmaci-a-h
Agency for the Negotiating Representation of Public Administrations (ARAN). Available from: https://www.aranagenzia.it/statistiche-e-pubblicazioni/dati-statistici.html
Job Pricing: All About Rewards – Salary Outlook 2019: Analysis of the Italian salary market – data updated to the second half. 2018. Available from: https://www.jobpricing.it/blog/project/salary-outlook-2019-prima-edizione/
Drummond, M.F.; Sculpher, M.J.; Claxton, K. Methods for the economic evaluation of health care programmes; Oxford University Press, 2015.
dos Santos Nunes, V.; El Dib, R.; Boguszewski, C.L.; Nogueira, C.R. Cabergoline versus bromocriptine in the treatment of hyperprolactinemia: A systematic review of randomized controlled trials and meta-analysis. Pituitary, 2011, 14(3), 259-265.
[http://dx.doi.org/10.1007/s11102-010-0290-z] [PMID: 21221817]
Almalki, M.H.; Aljoaib, N.N.; Alotaibi, M.J.; Aldabas, B.S.; Wahedi, T.S.; Ahmad, M.M.; Alshahrani, F. Temozolomide therapy for resistant prolactin-secreting pituitary adenomas and carcinomas: A systematic review. Hormones, 2017, 16(2), 139-149.
[http://dx.doi.org/10.14310/horm.2002.1729] [PMID: 28742502]
Carija, R.; Vucina, D. Frequency of pituitary tumor apoplexy during treatment of prolactinomas with dopamine agonists: A systematic review. CNS Neurol. Disord. Drug Targets, 2013, 11(8), 1012-1014.
[http://dx.doi.org/10.2174/1871527311211080011] [PMID: 23244423]
D’Sylva, C.; Khan, T.; Van Uum, S.; Fraser, L-A. Osteoporotic fractures in patients with untreated hyperprolactinemia vs. those taking dopamine agonists: A systematic review and meta-analysis. Neuroendocrinol. Lett., 2015, 36(8), 745-749.
[PMID: 26921574]
Huang, H.Y.; Lin, S.J.; Zhao, W.G.; Wu, Z.B. Cabergoline versus bromocriptine for the treatment of giant prolactinomas: A quantitative and systematic review. Metab. Brain Dis., 2018, 33(3), 969-976.
[http://dx.doi.org/10.1007/s11011-018-0217-3] [PMID: 29546691]
Jethwa, P.R.; Patel, T.D.; Hajart, A.F.; Eloy, J.A.; Couldwell, W.T.; Liu, J.K. Cost-effectiveness analysis of microscopic and endoscopic transsphenoidal surgery versus medical therapy in the management of microprolactinoma in the United States. World Neurosurg., 2016, 87, 65-76.
[http://dx.doi.org/10.1016/j.wneu.2015.10.090] [PMID: 26548828]
Baussart, B.; Villa, C.; Jouinot, A.; Raffin-Sanson, M.L.; Foubert, L.; Cazabat, L.; Bernier, M.; Bonnet, F.; Dohan, A.; Bertherat, J.; Assié, G.; Gaillard, S. Pituitary surgery as alternative to dopamine agonists treatment for microprolactinomas: A cohort study. Eur. J. Endocrinol., 2021, 185(6), 783-791.
[http://dx.doi.org/10.1530/EJE-21-0293] [PMID: 34605772]
Castinetti, F.; Albarel, F.; Amodru, V.; Cuny, T.; Dufour, H.; Graillon, T.; Morange, I.; Brue, T. The risks of medical treatment of prolactinoma. Ann. Endocrinol., 2021, 82(1), 15-19.
[http://dx.doi.org/10.1016/j.ando.2020.12.008] [PMID: 33373604]
Casanueva, F.F.; Barkan, A.L.; Buchfelder, M.; Klibanski, A.; Laws, E.R.; Loeffler, J.S.; Melmed, S.; Mortini, P.; Wass, J.; Giustina, A. Criteria for the definition of pituitary tumor centers of excellence (PTCOE): A pituitary society statement. Pituitary, 2017, 20(5), 489-498.
[http://dx.doi.org/10.1007/s11102-017-0838-2] [PMID: 28884415]
Losa, M.; Mortini, P.; Barzaghi, R.; Gioia, L.; Giovanelli, M. Surgical treatment of prolactin-secreting pituitary adenomas: Early results and long-term outcome. J. Clin. Endocrinol. Metab., 2002, 87(7), 3180-3186.
[http://dx.doi.org/10.1210/jcem.87.7.8645] [PMID: 12107221]

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