title: SHORT-TERM DECLINE IN PROLACTIN CONCENTRATIONS CAN PREDICT FUTURE PROLACTIN NORMALIZATION, TUMOR SHRINKAGE, AND TIME TO REMISSION IN MEN WITH MACROPROLACTINOMAS.
abstract: OBJECTIVE
  To identify early follow-up measures that will predict the dynamics of prolactin (PRL) decrease and adenoma shrinkage in men harboring macroprolactinomas.
  
  
  METHODS
  A single-center historical prospective study including a consecutive group of 71 men with pituitary macroadenomas (≥10 mm) and hyperprolactinemia (PRL >7 times the upper limit of normal [ULN]) treated medically with cabergoline. Comparisons of PRL normalization rates were performed according to PRL levels achieved at 6 months, maximal adenoma shrinkage during follow-up, and other patient characteristics. Correlations were analyzed to identify characteristics of PRL suppression dynamics.
  
  
  RESULTS
  PRL levels after 6 months of treatment correlated positively with current PRL levels (r = 0.74; P<.001), with time to PRL normalization (r = 0.75; P<.001), and with adenoma diameter following treatment (r = 0.38; P = .01). Adenoma shrinkage depicted by first magnetic resonance imaging on treatment correlated with maximal adenoma shrinkage during follow-up (r = 0.56; P = .006). Five patients had nadir PRL levels ≥3 times the ULN (51 ng/mL) and showed slower response to cabergoline treatment, with consistently higher PRL levels compared with responding patients throughout follow-up (mean 6-month PRL levels, 519 ± 403 ng/mL versus 59 ± 118 ng/mL; P<.001).
  
  
  CONCLUSIONS
  Six-month PRL level might serve as a surrogate marker for PRL normalization and adenoma shrinkage dynamics among men harboring macroprolactinomas.
authors.forename: Amit
authors.initials: A
authors.lastname: Tirosh
authors.forename: Carlos
authors.initials: C
authors.lastname: Benbassat
authors.forename: Ilan
authors.initials: I
authors.lastname: Shimon
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood; D000077465:Cabergoline; D015331:Cohort Studies; D015536:Down-Regulation; D004873:Ergolines / Q000627:therapeutic use*; D006801:Humans; D006966:Hyperprolactinemia / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D010911:Pituitary Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy* / Q000473:pathology; D011379:Prognosis; D011388:Prolactin / Q000097:blood*; D015175:Prolactinoma / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy* / Q000473:pathology; D012074:Remission Induction; D013997:Time Factors; D047368:Tumor Burden; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor; D004873:Ergolines; D011388:Prolactin; D000077465:Cabergoline