Analysis of the factors influencing early prolactin remission after endoscopic resection of aggressive prolactinomas

Objective To explore the influencing factors of early prolactin remission after endoscopic resection of aggressive prolactinomas.Methods A total of 141 patients with aggressive prolactinomas who underwent endoscopic pituitary lesion resection in the Affiliated Hospital of Xuzhou Medical University from January 2017 to December 2022 were selected and their clinical data were retrospectively analyzed. According to their prolactin levels two weeks after surgery, the patients were divided into two groups: an early remission group and a non-remission group. Their clinical data were compared through univariate analysis, while multivariate logistic regression analysis was performed to determine the independent factors predicting early postoperative prolactin remission.Results Among the 141 patients undergoing surgery for aggressive prolactinomas, 121 patients (85.82%) achieved early remission, but 20 patients (14.18%) failed. Statistical differences were found between the early remission and non-remission groups in gender, tumor size, the extent of tumor resection, preoperative prolactin levels, and the prolactin levels on postoperative day one. According to multivariate logistic regression analysis, the prolactin levels on postoperative day one are an independent factor predicting early postoperative prolactin remission in patients with aggressive prolactinomas.Conclusions Patients with aggressive prolactinomas are easier to achieve early remission if their prolactin levels on postoperative day one are normal, with lower tumor metastasis, smaller tumor diameters, preoperative PRL levels ＜200 μg/L, and complete endoscopic tumor resection.