title: Prolactinomas in men: a multicentre and retrospective analysis of treatment outcome.
abstract: OBJECTIVE
  To assess treatment outcome in male patients with micro- and macroprolactinomas.
  
  
  METHODS
  Multicentre and retrospective study.
  
  
  METHODS
  Eighty-eight male patients (15 micro- and 73 macroprolactinomas), aged 40·3 ± 14·7 years, were studied. Time of follow-up ranged from 3 to 244 months.
  
  
  METHODS
  Clinical, hormonal and radiological data were registered at diagnosis and follow-up. Treatment outcome was evaluated in relation to the modality of therapy (dopamine agonists, surgery and radiation therapy).
  
  
  RESULTS
  Dopamine agonists normalized prolactin levels in 73·3% and 65·2% of patients with micro- and macroprolactinomas, respectively. Disappearance of tumour was reached in 53·3% and 28·3% of subjects with micro- and macroprolactinomas, respectively. Tumour absence at last visit was achieved in 7 of 14 patients with macroprolactinoma and treated by means of dual therapy (dopamine agonists and neurosurgery) and in 9 of 13 patients with macroprolactinoma managed with triple therapy (dopamine agonists, neurosurgery and radiation therapy). Normalization of prolactin levels at last visit was present in 68·9%, 79·6% and 69·2% of patients treated by medical therapy, dual therapy and triple therapy, respectively (differences not significant). Multivariate logistic regression analysis showed that the time on therapy was the only significant variable related to tumour disappearance.
  
  
  CONCLUSIONS
  We conclude that medical therapy normalizes prolactin and reduces tumour size in the majority of men with prolactinomas. The addition of pituitary surgery with or without radiation therapy does not offer significant advantages over medical therapy with dopamine agonists in male patients with macroprolactinomas.
authors.affiliation: Department of Endocrinology, Hospital Ramón y Cajal, Madrid, Spain.
authors.forename: Pedro
authors.initials: P
authors.lastname: Iglesias
authors.forename: Carmen
authors.initials: C
authors.lastname: Bernal
authors.forename: Carles
authors.initials: C
authors.lastname: Villabona
authors.forename: José C
authors.initials: JC
authors.lastname: Castro
authors.forename: Francisco
authors.initials: F
authors.lastname: Arrieta
authors.forename: Juan J
authors.initials: JJ
authors.lastname: Díez
mesh_terms: D000328:Adult; D018491:Dopamine Agonists / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011388:Prolactin / Q000378:metabolism*; D015175:Prolactinoma / Q000188:drug therapy* / Q000378:metabolism*; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D018491:Dopamine Agonists; D011388:Prolactin