| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
CLINICAL STUDY |
Department of Neurosurgery, University of Erlangen-Nürnberg, Erlangen, Germany
(Correspondence should be addressed to P Nomikos, who is now at Department of Neurosurgery and Gamma Knife Radiosurgery, HYGEIA Hospital 4, Erythrou Stavrou & Kifisias Ave, 15123 Maroussi, Greece; Email: nomikosp{at}otenet.gr)
Background and aim: The aim of this study was to illustrate the present role of transsphenoidal surgery as primary therapy in GH-secreting adenomas, and to compare the results concerning control of disease with previous series using older criteria of cure.
Method: We report on a consecutive series of 688 acromegalic patients treated over a time period of 19 years. Biochemical cure was defined as normalisation of basal GH level, suppression of GH levels to below 1 ng/ml during an oral glucose load and normalisation of IGF-I levels. Of the 506 patients undergoing primary transsphenoidal surgery, a total of 57.3% postoperatively fulfilled the criteria used.
Results: The rate of biochemical ‘cure’ correlated with the magnitude of the initial GH levels, the tumour size and invasion. The overall complication rate was below 2%. Mortality in this series was 0.1% (1 of 688). During a follow-up period of 10.7 years only two recurrences (0.4%) occurred. However, in the patients treated by transcranial surgery and by repeat surgery the cure rate was found to be relatively low (5.2 and 21.3% respectively).
Conclusions: These data suggest that surgery remains with very few exceptions the primary treatment of acromegaly for (i) a high cure rate, (ii) low morbidity, (iii) low recurrence rate and (iv) immediate decline of GH. Based on current criteria of cure, recurrences are uncommon. However, cure by surgery alone is improbable in patients harbouring extended, invasive tumours with high secretory activity, in whom further adjuvant treatment is mandatory.
This article has been cited by other articles:
|
|
 |
|
  M. Losa, L. Gioia, P. Picozzi, A. Franzin, M. Valle, M. Giovanelli, and P. Mortini The Role of Stereotactic Radiotherapy in Patients with Growth Hormone-Secreting Pituitary Adenoma J. Clin. Endocrinol. Metab., July 1, 2008; 93(7): 2546 - 2552. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Fusco, M. C. Zatelli, A. Bianchi, V. Cimino, L. Tilaro, F. Veltri, F. Angelini, L. Lauriola, V. Vellone, F. Doglietto, et al. Prognostic Significance of the Ki-67 Labeling Index in Growth Hormone-Secreting Pituitary Adenomas J. Clin. Endocrinol. Metab., July 1, 2008; 93(7): 2746 - 2750. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Nachtigall, A. Delgado, B. Swearingen, H. Lee, R. Zerikly, and A. Klibanski Changing Patterns in Diagnosis and Therapy of Acromegaly over Two Decades J. Clin. Endocrinol. Metab., June 1, 2008; 93(6): 2035 - 2041. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. Saeger, D. K Ludecke, M. Buchfelder, R. Fahlbusch, H.-J. Quabbe, and S. Petersenn Pathohistological classification of pituitary tumors: 10 years of experience with the German Pituitary Tumor Registry Eur. J. Endocrinol., February 1, 2007; 156(2): 203 - 216. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Cozzi, M. Montini, R. Attanasio, M. Albizzi, G. Lasio, S. Lodrini, P. Doneda, L. Cortesi, and G. Pagani Primary Treatment of Acromegaly with Octreotide LAR: A Long-Term (Up to Nine Years) Prospective Study of Its Efficacy in the Control of Disease Activity and Tumor Shrinkage J. Clin. Endocrinol. Metab., April 1, 2006; 91(4): 1397 - 1403. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Colao, R. Attanasio, R. Pivonello, P. Cappabianca, L. M. Cavallo, G. Lasio, A. Lodrini, G. Lombardi, and R. Cozzi Partial Surgical Removal of Growth Hormone-Secreting Pituitary Tumors Enhances the Response to Somatostatin Analogs in Acromegaly J. Clin. Endocrinol. Metab., January 1, 2006; 91(1): 85 - 92. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G M Besser, P Burman, and A F Daly Predictors and rates of treatment-resistant tumor growth in acromegaly Eur. J. Endocrinol., August 1, 2005; 153(2): 187 - 193. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Fahlbusch, B. v Keller, O. Ganslandt, J. Kreutzer, and C. Nimsky Transsphenoidal surgery in acromegaly investigated by intraoperative high-field magnetic resonance imaging Eur. J. Endocrinol., August 1, 2005; 153(2): 239 - 248. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
