Acromegaly: surgical results in 548 patients
| Autor: | José García-Uría, Cecilia Fernández Mateos, Maria García-Uria, Tomás Lucas Morante |
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| Rok vydání: | 2017 |
| Předmět: |
Surgical results
Adenoma Adult Male medicine.medical_specialty Adolescent Endocrinology Diabetes and Metabolism First line medicine.medical_treatment 030209 endocrinology & metabolism Transsphenoidal approach 03 medical and health sciences Young Adult 0302 clinical medicine Endocrinology Acromegaly medicine Humans Pituitary Neoplasms Child Aged Retrospective Studies business.industry Non invasive Human physiology Microsurgery Middle Aged medicine.disease Magnetic Resonance Imaging Surgery Female Neoplasm Recurrence Local business 030217 neurology & neurosurgery |
| Zdroj: | Pituitary. 20(5) |
| ISSN: | 1573-7403 |
| Popis: | The goal of this study was to quantified the results of microsurgery, in all the patients with acromegaly treated by the same endocrinologist and the same surgeon between 1975 and 2015. A series of 548 patients with acromegaly were operated and followed-up from 6 months to 40 years. Patients were selected according to five criteria: (1) Operated by the same surgeon. (2) No previous treatment. (3) Complete endocrinological preoperative studies including GH, OGTT, IGF-I, PRL test and TC/MRI. (4) Complete postoperative endocrinological evaluation for at least one determination of GH, OGTT, PRL test and IGF-I six months after surgery. (5) All the patients were supervised by the same endocrinologist. Microadenomas were present in 119 patients and 109 (91,5%) achieved remission. Non invasive macroadenomas were present in 200 patients and 164 achieved remission (82%). Results were worse for invasive macroadenomas but even with great invasions some patients achieved clinical remission. Follow-up range from 6 months to 40 years (mean 3.3 ± 2.3) A long term follow-up of 15 years was achieved in 61 patients. Four of them had a recurrence 4, 7, 8, 12 years after surgery (6.5%). There was not mortality and the rate of complications was low. Surgery remains the first line of therapy for a majority of acromegalic patients. This series proves to be very valuable in circumscribed adenomas but also in invasive tumours. Levels of GH and IGF-I were decreased in almost all the patients without remission. |
| Databáze: | OpenAIRE |
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