A single-center observational study assessing the predictive factors associated with the prognosis of acromegaly. (December 2020)

• Record Type: Journal Article
• Authors: Diri, Halit; Ozaslan, Ersin; Kurtsoy, Ali; Bayram, Fahri
• Is Part Of: Growth hormone & IGF research. Volume 55(2020)
• Publication Date: 2020-12
• Subjects: Acromegaly -- Prediction -- Prognosis; Growth regulators -- Periodicals; Growth -- Regulation -- Periodicals; Somatomedin -- Periodicals; Somatomedins -- Periodicals; Growth Hormone -- Periodicals; Growth Substances -- Periodicals; Croissance -- Régulation -- Périodiques; Croissance -- Régulateurs -- Périodiques; Somatotrophine -- Périodiques; Somatomédine -- Périodiques; Growth -- Regulation; Growth regulators; Electronic journals; Periodicals; Electronic journals; 612.4
• DOI: 10.1016/j.ghir.2020.101342
• Languages: English
• ISSNs: 1096-6374

Abstract

Abstract: Aim: The aim of this study was to clarify the prognostic values of various preoperative factors, including the surgeon's ability as well as the patient's age, gender, tumor size, cavernous sinus invasion, compression of the optic chiasm, hypopituitarism, immunohistochemical (IHC) staining pattern of the adenoma, and insulin-like growth factor-1 (IGF-1) level, in acromegalic patients who had undergone pituitary surgery. Study design: This single-center, retrospective study assessed the medical records of 108 patients who had undergone pituitary surgery with the same neurosurgical team. Results: The mean total follow-up period after surgery was 44.8 (min: 24, max: 59) months. Remission was reported in 67 (62.0%) patients, and 57 (52.8%) patients did not experience recurrence. Initial tumor volume, IGF-1 level, and optic chiasm compression, but not patients' age, gender, cavernous sinus invasion, and IHC staining patterns of the adenoma, were prognostic of either remission or recurrence. An IGF-1 level of 860 ng/mLwas found to be a convenient cut-off point for determining remission. Conclusions: The experience of the surgical team suggests that the initial tumor volume, IGF-1 level, and optic chiasm compression have high prognostic values in relation to pituitary surgery for patients with acromegaly. Highlights: A successful surgical team is of primary importance for predicting the prognosis after pituitary surgery. The initial tumor volume, IGF-1 level, and optic chiasm compression have high prognostic values in relation to acromegaly. The patients' age, gender, and cavernous sinus invasion were not prognostic of remission or recurrence. A pre-operative IGF-1 level of 860 ng/mL is a convenient cut-off point for determining remission.