Cargando…

Prolonged preoperative treatment of acromegaly with Somatostatin analogs may improve surgical outcome in patients with invasive pituitary macroadenoma (Knosp grades 1–3): a retrospective cohort study conducted at a single center

BACKGROUND: This study aimed to investigate preoperative somatostatin analogs (SSAs) treatment on the surgical outcome in patients with acromegaly. METHODS: An analysis of 358 patients with acromegaly was conducted. The preoperative medical therapy group (81 patients) received SSA treatment for at l...

Descripción completa

Detalles Bibliográficos
Autores principales: Duan, Lian, Zhu, Huijuan, Xing, Bing, Gu, Feng
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5585918/
https://www.ncbi.nlm.nih.gov/pubmed/28874187
http://dx.doi.org/10.1186/s12902-017-0205-3
_version_ 1783261716649345024
author Duan, Lian
Zhu, Huijuan
Xing, Bing
Gu, Feng
author_facet Duan, Lian
Zhu, Huijuan
Xing, Bing
Gu, Feng
author_sort Duan, Lian
collection PubMed
description BACKGROUND: This study aimed to investigate preoperative somatostatin analogs (SSAs) treatment on the surgical outcome in patients with acromegaly. METHODS: An analysis of 358 patients with acromegaly was conducted. The preoperative medical therapy group (81 patients) received SSA treatment for at least 3 months prior to surgery, while the primary surgery group (277 patients) underwent transsphenoidal surgery directly. Follow-up duration was ≥3 months. Tumor invasion was evaluated by magnetic resonance imaging (MRI) and classified according to the Knosp grading system. RESULTS: Most patients were diagnosed with macroadenoma. Among all patients (Knosp grades 0–4), preoperative SSA therapy did not significantly improve the curative effect of surgery, according to the levels of growth hormone (GH) and/or insulin-like growth factor 1 (IGF-1) markers. In patients with macroadenoma (Knosp grades 1–3), the remission rates were significantly higher in the SSA group compared to the surgery group when considering GH (56.4% vs. 37.3%, P = 0.048) and IGF-1 (43.2% vs. 17.6%, P = 0.004). In the preoperative medical therapy group, long-term use of SSAs (>6 months) led to higher remission rates (GH, 72.2% vs. 51.0%; and IGF-1, 61.1% vs. 29.8%; P = 0.12 and 0.02, respectively]. CONCLUSIONS: The long-term preoperative SSAs treatment may improve the surgical curative rate in acromegalic patients with invasive macroadenomas (Knosp grades 1–3). ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12902-017-0205-3) contains supplementary material, which is available to authorized users.
format Online
Article
Text
id pubmed-5585918
institution National Center for Biotechnology Information
language English
publishDate 2017
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-55859182017-09-06 Prolonged preoperative treatment of acromegaly with Somatostatin analogs may improve surgical outcome in patients with invasive pituitary macroadenoma (Knosp grades 1–3): a retrospective cohort study conducted at a single center Duan, Lian Zhu, Huijuan Xing, Bing Gu, Feng BMC Endocr Disord Research Article BACKGROUND: This study aimed to investigate preoperative somatostatin analogs (SSAs) treatment on the surgical outcome in patients with acromegaly. METHODS: An analysis of 358 patients with acromegaly was conducted. The preoperative medical therapy group (81 patients) received SSA treatment for at least 3 months prior to surgery, while the primary surgery group (277 patients) underwent transsphenoidal surgery directly. Follow-up duration was ≥3 months. Tumor invasion was evaluated by magnetic resonance imaging (MRI) and classified according to the Knosp grading system. RESULTS: Most patients were diagnosed with macroadenoma. Among all patients (Knosp grades 0–4), preoperative SSA therapy did not significantly improve the curative effect of surgery, according to the levels of growth hormone (GH) and/or insulin-like growth factor 1 (IGF-1) markers. In patients with macroadenoma (Knosp grades 1–3), the remission rates were significantly higher in the SSA group compared to the surgery group when considering GH (56.4% vs. 37.3%, P = 0.048) and IGF-1 (43.2% vs. 17.6%, P = 0.004). In the preoperative medical therapy group, long-term use of SSAs (>6 months) led to higher remission rates (GH, 72.2% vs. 51.0%; and IGF-1, 61.1% vs. 29.8%; P = 0.12 and 0.02, respectively]. CONCLUSIONS: The long-term preoperative SSAs treatment may improve the surgical curative rate in acromegalic patients with invasive macroadenomas (Knosp grades 1–3). ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12902-017-0205-3) contains supplementary material, which is available to authorized users. BioMed Central 2017-09-06 /pmc/articles/PMC5585918/ /pubmed/28874187 http://dx.doi.org/10.1186/s12902-017-0205-3 Text en © The Author(s). 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Duan, Lian
Zhu, Huijuan
Xing, Bing
Gu, Feng
Prolonged preoperative treatment of acromegaly with Somatostatin analogs may improve surgical outcome in patients with invasive pituitary macroadenoma (Knosp grades 1–3): a retrospective cohort study conducted at a single center
title Prolonged preoperative treatment of acromegaly with Somatostatin analogs may improve surgical outcome in patients with invasive pituitary macroadenoma (Knosp grades 1–3): a retrospective cohort study conducted at a single center
title_full Prolonged preoperative treatment of acromegaly with Somatostatin analogs may improve surgical outcome in patients with invasive pituitary macroadenoma (Knosp grades 1–3): a retrospective cohort study conducted at a single center
title_fullStr Prolonged preoperative treatment of acromegaly with Somatostatin analogs may improve surgical outcome in patients with invasive pituitary macroadenoma (Knosp grades 1–3): a retrospective cohort study conducted at a single center
title_full_unstemmed Prolonged preoperative treatment of acromegaly with Somatostatin analogs may improve surgical outcome in patients with invasive pituitary macroadenoma (Knosp grades 1–3): a retrospective cohort study conducted at a single center
title_short Prolonged preoperative treatment of acromegaly with Somatostatin analogs may improve surgical outcome in patients with invasive pituitary macroadenoma (Knosp grades 1–3): a retrospective cohort study conducted at a single center
title_sort prolonged preoperative treatment of acromegaly with somatostatin analogs may improve surgical outcome in patients with invasive pituitary macroadenoma (knosp grades 1–3): a retrospective cohort study conducted at a single center
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5585918/
https://www.ncbi.nlm.nih.gov/pubmed/28874187
http://dx.doi.org/10.1186/s12902-017-0205-3
work_keys_str_mv AT duanlian prolongedpreoperativetreatmentofacromegalywithsomatostatinanalogsmayimprovesurgicaloutcomeinpatientswithinvasivepituitarymacroadenomaknospgrades13aretrospectivecohortstudyconductedatasinglecenter
AT zhuhuijuan prolongedpreoperativetreatmentofacromegalywithsomatostatinanalogsmayimprovesurgicaloutcomeinpatientswithinvasivepituitarymacroadenomaknospgrades13aretrospectivecohortstudyconductedatasinglecenter
AT xingbing prolongedpreoperativetreatmentofacromegalywithsomatostatinanalogsmayimprovesurgicaloutcomeinpatientswithinvasivepituitarymacroadenomaknospgrades13aretrospectivecohortstudyconductedatasinglecenter
AT gufeng prolongedpreoperativetreatmentofacromegalywithsomatostatinanalogsmayimprovesurgicaloutcomeinpatientswithinvasivepituitarymacroadenomaknospgrades13aretrospectivecohortstudyconductedatasinglecenter