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

M Taghavi; R Abutorabi; R Rajabian; MH Khazaei

International Journal of Endocrinology and Metabolism

Research Institute for Endocrine Sciences

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

Author(s):

M Taghavi^1,*,

R Abutorabi²,

R Rajabian²,

MH Khazaei²

1Endocrine Research Center, Ghaem Hospital, Mashhad University of Medical Sciences, mortezataghavi2003@yahoo.com, I.R.Iran

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

International Journal of Endocrinology and Metabolism:Vol. 5, issue 4; 147-152

Article type:Research Article

Received:Apr 04, 2007

Accepted:Aug 11, 2007

How to Cite:M TaghaviR AbutorabiR RajabianMH KhazaeiSurgery for Acromegaly: The Outcome Based on Stringent Criteria of Remission.Int J Endocrinol Metab.5(4):147-152.

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.

Keywords

Acromegary

Surgery

Remission criteria

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