LU Jianglong,CAI Lin,WU Jinsen, et al. Drug versus surgery treatment for patients with microprolactinoma in China: a Meta-analysis[J]. JOURNAL OF WEZHOU MEDICAL UNIVERSITY, 2016, 46(8): 610-614.
Abstract：Objective: To evaluate the efficacy and safety of drug versus surgery treatment for patients with microprolactinoma in China. Methods: Case-control trials of drug versus surgery treatment for patients with microprolactinoma in China were collected from PubMed, Embase, Wanfang, VIP and CNKI databases, then systematic review and meta-analysis was conducted. Results: A total of 12 case-control trials involving 1 671 patients were included, and the average follow-up time was more than 6 months. As for the total effective rate, including normalization of prolactin levels, normalization of the menstrual cycle and disappearance of galactorrhea, no significant differences were found between drug treatment group and surgery treatment group. The incidence of side effects was higher in drug treatment group than that in surgery treatment group (OR=3.27, 95%CI: 2.191～4.90, P<0.001). In patients with prolactin levels less than 200 ng/mL before treatment, the rate of normoprolactinemia was lower in drug treatment group than that in surgery treatment group (OR=0.34, 95%CI: 0.17～0.68, P=0.002). Conclusion: Observational evidence supports that the surgical options should at least be discussed for microprolactinomas, especially with prolactin levels less than 200 ng/mL, provids that an experienced pituitary neurosurgeon is available. Patients should be explained that medical therapy may need to be continued for many years and surgery has about 70 % chance of solving the problem permanently.
