N. Çetinalp, Gamze Akkus, G. Seydaoglu, K. Ozsoy, Mevlana Akbaba, Okay Baykara, K. Oktay, T. Erman
{"title":"EARLY PREDICTORS OF REMISSION IN ACROMEGALY PATIENTS AFTER PURE ENDOSCOPIC ENDONASAL TRANSSPHENOIDAL SURGERY","authors":"N. Çetinalp, Gamze Akkus, G. Seydaoglu, K. Ozsoy, Mevlana Akbaba, Okay Baykara, K. Oktay, T. Erman","doi":"10.1055/a-2319-0344","DOIUrl":null,"url":null,"abstract":"Surgery is the first line treatment in acromegaly but it takes months to confirm remission. It is crucial to determine remission early in order to inform the patient and plan further treatment options. We aimed to evaluate the predictors of remission at the early phase after endoscopic endonasal pituitary surgery in acromegaly patients. \nMethods: Fifty-four GH-adenoma patients operated via pure endoscopic endonasal approach were analysed in this observational study. We compared the basic clinical, radiological characteristics, and the preoperative and postoperative hormone levels in terms of remission according to current guidelines.\nResults: The surgical remission rate was 61.1%. When the patients were compared according to surgical remission, the age, gender, and immunohistochemical granulation type were non-significant, while diabetes mellitus was more common (55.6% vs 44.4%), the preoperative tumor volume (1.2 0.9 cm3 vs 4.1 4.2 cm3), postoperative GH and IGF-1 levels were higher in the non-remission group (p0.05). We defined a number of cut-off values of both GH and IGF-1 levels to predict remission at the postoperative phase. Age standardized regression analyses showed that postoperative day 1 (POD-1) GH levels (OR:8.9; 95%CI:1.99-40.0, p=0.004) and tumor volume (OR:3.14; 95%CI:1.09-9.0, p=0.034) were found to be significant independent predictors for remission.\n\n\nConclusion: We demonstrated that tumor volume and POD1 GH levels are independent predictors of remission in acromegaly patients operated via pure endoscopic endonasal technique and may be used as an early marker of remission and this may lead to taking adjuvant medical therapies early into account to improve prognosis. \n","PeriodicalId":16513,"journal":{"name":"Journal of Neurological Surgery Part B: Skull Base","volume":null,"pages":null},"PeriodicalIF":0.9000,"publicationDate":"2024-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Neurological Surgery Part B: Skull Base","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1055/a-2319-0344","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
Abstract
Surgery is the first line treatment in acromegaly but it takes months to confirm remission. It is crucial to determine remission early in order to inform the patient and plan further treatment options. We aimed to evaluate the predictors of remission at the early phase after endoscopic endonasal pituitary surgery in acromegaly patients.
Methods: Fifty-four GH-adenoma patients operated via pure endoscopic endonasal approach were analysed in this observational study. We compared the basic clinical, radiological characteristics, and the preoperative and postoperative hormone levels in terms of remission according to current guidelines.
Results: The surgical remission rate was 61.1%. When the patients were compared according to surgical remission, the age, gender, and immunohistochemical granulation type were non-significant, while diabetes mellitus was more common (55.6% vs 44.4%), the preoperative tumor volume (1.2 0.9 cm3 vs 4.1 4.2 cm3), postoperative GH and IGF-1 levels were higher in the non-remission group (p0.05). We defined a number of cut-off values of both GH and IGF-1 levels to predict remission at the postoperative phase. Age standardized regression analyses showed that postoperative day 1 (POD-1) GH levels (OR:8.9; 95%CI:1.99-40.0, p=0.004) and tumor volume (OR:3.14; 95%CI:1.09-9.0, p=0.034) were found to be significant independent predictors for remission.
Conclusion: We demonstrated that tumor volume and POD1 GH levels are independent predictors of remission in acromegaly patients operated via pure endoscopic endonasal technique and may be used as an early marker of remission and this may lead to taking adjuvant medical therapies early into account to improve prognosis.
期刊介绍:
The Journal of Neurological Surgery Part B: Skull Base (JNLS B) is a major publication from the world''s leading publisher in neurosurgery. JNLS B currently serves as the official organ of several national and international neurosurgery and skull base societies.
JNLS B is a peer-reviewed journal publishing original research, review articles, and technical notes covering all aspects of neurological surgery. The focus of JNLS B includes microsurgery as well as the latest minimally invasive techniques, such as stereotactic-guided surgery, endoscopy, and endovascular procedures. JNLS B is devoted to the techniques and procedures of skull base surgery.