Acromegaly is a rare disease with increased mor-tality rate. Present literature documents the treatment of choice for acromegaly is surgery, curative in 91% of pituitary microadenomas and up to 73% of macroadenomas. The aim of this study was to present our experience in the diag-nosis and treatment of a series of patients suffer-ing from acromegaly, and to compare the results concerning control of disease with other series using modern criteria for therapy. Materials and Methods: Of fifty patients (31 men, 19 women) referring to the Mashhad Endo-crine Out-patient Clinic between 2001 and 2005, diagnosed with acrimegaly. 40 underwent sur-gery as initial therapy. We used a combination of modern, evidence-based remission criteria in-cluding basal GH below 2.5 µg/L (5 mU/L), a na-dir GH below than 1.0 µg/L (2 mU/L) after an oral glucose tolerance test, and normal age-related IGF-I levels 6 months after surgery for the definition of cure in our patients. Results: Fifteen of the 40 patients operated (37.5%) remained in remission after just transsphenoidal surgery; 80% of patients with microadenomas but only 31.4% of patients with macroadenomas achieved remission; 50% intrasellar macroade-nomas showed remission, compared with only 21.7% extrasellar extended macroadenomas. The rate of biochemical ‘cure’ correlated with the magnitude of the initial GH levels, the tumor size and invasion. Conclusion: In conclusion, using stringent crite-ria of remission, our results compared well with similar series of microadenomas and intrasellar macroadenomas, whereas outcomes for extrasel-lar macroadenomas were less than satisfactory.

"/> Acromegaly is a rare disease with increased mor-tality rate. Present literature documents the treatment of choice for acromegaly is surgery, curative in 91% of pituitary microadenomas and up to 73% of macroadenomas. The aim of this study was to present our experience in the diag-nosis and treatment of a series of patients suffer-ing from acromegaly, and to compare the results concerning control of disease with other series using modern criteria for therapy. Materials and Methods: Of fifty patients (31 men, 19 women) referring to the Mashhad Endo-crine Out-patient Clinic between 2001 and 2005, diagnosed with acrimegaly. 40 underwent sur-gery as initial therapy. We used a combination of modern, evidence-based remission criteria in-cluding basal GH below 2.5 µg/L (5 mU/L), a na-dir GH below than 1.0 µg/L (2 mU/L) after an oral glucose tolerance test, and normal age-related IGF-I levels 6 months after surgery for the definition of cure in our patients. Results: Fifteen of the 40 patients operated (37.5%) remained in remission after just transsphenoidal surgery; 80% of patients with microadenomas but only 31.4% of patients with macroadenomas achieved remission; 50% intrasellar macroade-nomas showed remission, compared with only 21.7% extrasellar extended macroadenomas. The rate of biochemical ‘cure’ correlated with the magnitude of the initial GH levels, the tumor size and invasion. Conclusion: In conclusion, using stringent crite-ria of remission, our results compared well with similar series of microadenomas and intrasellar macroadenomas, whereas outcomes for extrasel-lar macroadenomas were less than satisfactory.

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Surgery for Acromegaly: The Outcome Based on Stringent Criteria of Remission

AUTHORS

M Taghavi 1 , * , R Abutorabi 2 , R Rajabian 2 , MH Khazaei 2

1 Endocrine Research Center, Ghaem Hospital, Mashhad University of Medical Sciences, [email protected], I.R.Iran

2 Endocrine Research Center, Ghaem Hospital, Mashhad University of Medical Sciences, I.R.Iran

How to Cite: Taghavi M, Abutorabi R, Rajabian R, Khazaei M. Surgery for Acromegaly: The Outcome Based on Stringent Criteria of Remission, Int J Endocrinol Metab. Online ahead of Print ; 5(4):147-152.

ARTICLE INFORMATION

International Journal of Endocrinology and Metabolism: 5 (4); 147-152
Article Type: Original Article
Received: April 4, 2007
Accepted: August 11, 2007
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Abstract

Acromegaly is a rare disease with increased mor-tality rate. Present literature documents the treatment of choice for acromegaly is surgery, curative in 91% of pituitary microadenomas and up to 73% of macroadenomas. The aim of this study was to present our experience in the diag-nosis and treatment of a series of patients suffer-ing from acromegaly, and to compare the results concerning control of disease with other series using modern criteria for therapy. Materials and Methods: Of fifty patients (31 men, 19 women) referring to the Mashhad Endo-crine Out-patient Clinic between 2001 and 2005, diagnosed with acrimegaly. 40 underwent sur-gery as initial therapy. We used a combination of modern, evidence-based remission criteria in-cluding basal GH below 2.5 µg/L (5 mU/L), a na-dir GH below than 1.0 µg/L (2 mU/L) after an oral glucose tolerance test, and normal age-related IGF-I levels 6 months after surgery for the definition of cure in our patients. Results: Fifteen of the 40 patients operated (37.5%) remained in remission after just transsphenoidal surgery; 80% of patients with microadenomas but only 31.4% of patients with macroadenomas achieved remission; 50% intrasellar macroade-nomas showed remission, compared with only 21.7% extrasellar extended macroadenomas. The rate of biochemical ‘cure’ correlated with the magnitude of the initial GH levels, the tumor size and invasion. Conclusion: In conclusion, using stringent crite-ria of remission, our results compared well with similar series of microadenomas and intrasellar macroadenomas, whereas outcomes for extrasel-lar macroadenomas were less than satisfactory.

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