Outcome of surgical intrasellar growth hormone tumor performed by a pituitary specialist surgeon in a developing country
| Autor: | Michele Schops, Ítalo Mota, Tania Ferraz, Joao Paulo Almeida, Dayse Studart, Jackson A. Gondim, Erika Gomes |
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| Rok vydání: | 2007 |
| Předmět: |
Adenoma
Adult Male Reoperation medicine.medical_specialty Antineoplastic Agents Hormonal National Health Programs medicine.medical_treatment Cost-Benefit Analysis Octreotide Neurosurgical Procedures Young Adult Pituitary adenoma Acromegaly Outcome Assessment Health Care Sphenoid Bone medicine Humans Sella Turcica Treatment Failure Developing Countries Aged Retrospective Studies Transsphenoidal surgery business.industry Retrospective cohort study Endoscopy Middle Aged medicine.disease Growth hormone secretion Surgery Radiography Treatment Outcome Cavernous sinus Female Neurology (clinical) Neurosurgery Growth Hormone-Secreting Pituitary Adenoma business Brazil Specialization |
| Zdroj: | Surgical neurology. 72(1) |
| ISSN: | 1879-3339 |
| Popis: | Background Acromegaly is an excessive GH secretion, which in most cases, is caused by a pituitary GH-secreting adenoma. Traditional treatment of acromegaly consists of surgery, drug therapy, and eventually radiotherapy. The aim of this retrospective study is to evaluate the results of transsphenoidal endoscopic surgery in a group of patients with intrasellar GH adenoma who were operated by a pituitary specialist surgeon. We shall then argue about the economical advantages, for the NHS of a developing country, between surgical and medical treatment. Methods We have analyzed data from 33 patients with intrasellar GH tumor who had been referred to the neuroendocrine department of the HGF, Brazil. The patients underwent a transsphenoidal endoscopic adenomectomy for acromegaly between 2000 and 2005. Their ages were between 20 and 67 years (mean, 44 years) at the moment of surgery. No cavernous sinus invasion was present. Follow-up was a median of 2 years (range, 12 months-6 years). Results All 33 patients had intrasellar adenoma, 84.84% of patients achieved remission by surgery. One patient was operated twice and reached hormonal normalization. Five patients still had the disease and refused a second surgery. A treatment with octreotide was started for these 5 patients and resulted in an adequate control of GH and IGF-1 levels. No patients had radiotherapy. Conclusion Our patients, with intrasellar GH tumor, operated by a pituitary specialist neurosurgeon had remission rates approaching those obtained by most specialized neurosurgical centers worldwide. For equal results, our study shows that the surgical treatment is the best issue for the patient and for the NHS. |
| Databáze: | OpenAIRE |
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