FRI299 Efficacy And Safety Of Endoscopic Transsphenoidal Resection For Prolactinoma: A Retrospective Case-series

Disclosure: I.M. Zandbergen: None. K. Huntoon: None. T.G. White: None. F. de Vries: None. B. Moclair: None. W.R. Van Furth: None. I.C. Pelsma: None. A. Dehdashti: None. N.R. Biermasz: None. D.M. Prevedello: None. Introduction Endoscopic transsphenoidal surgery (ETSS) for prolactinoma is mainly reserved for patients with dopamine agonist (DA) resistance, intolerance, or apoplexy. Surgery as a first-line treatment remains a topic of debate. Therefore, published patient cohorts are often not representative for the total population, and lack long-term follow-up. High remission rates (overall 67%, microprolactinoma up to 90%) have been reported, with recurrence in 5-20%, and low complication rates. This study aimed to assess clinical efficacy and safety of ETSS in prolactinoma patients. Study design Multicenter retrospective chart review of 137 surgically treated prolactinoma patients (mean age 38.2±13.7 years; 61.3% female) from three tertiary care centers from the USA and the Netherlands. Clinical characteristics and outcomes of surgery, including long-term (>2 years postoperatively) biochemical remission, resolution of hypogonadism and visual deficiencies, and recurrence and complication rates were assessed. Main results Median highest preoperative prolactin levels -available for 115 patients- were 168.5 µg/L (97.5 - 836.5 µg/L) and were higher for males (996.4 µg/L (158.6 - 2145.0 µg/L) vs females 128.5 µg/L (83.7 - 223.0 µg/L), P