Abstract | OBJECTIVE: METHODS: We retrospectively reviewed 87 patients who had undergone transsphenoidal surgery for acromegaly. Demographic, radiological, and endocrinological data were reviewed before, immediately after, 3 months after, and in the long term (2.4 ± 1.1 years) after surgery. The definition of DR was that patients did not achieve GH remission immediately, 3 months, or later after surgery, but did so in the long term without any additional postoperative treatment. RESULTS: Fifty-one patients (58.6%) achieved long-term GH remission. There were 24 (27.6%) DR patients immediately postoperatively and 9 (10.3%) DR patients 3 months postoperatively. On average, the 24 DR patients achieved remission at 10.2 (range, 3-32) months. Immediate postoperative random and nadir GH after an oral glucose load were significantly lower in the DR group than in the nonremission group (2.73 ± 3.17 and 2.03 ± 2.59 vs. 8.05 ± 10.35 and 5.55 ± 5.91 μg/L, respectively). Three-month postoperative nadir GH was significantly lower in the DR group than in the nonremission group (1.63 ± 2.82 vs. 3.48 ± 4.25 μg/L, P = 0.007). Immediate postoperative random GH effectively predicted long-term remission (Spearman's ρ = 0.513, area under the curve = 0.905 > 0.90). However, the best predictor of long-term remission was 3-month postoperative nadir GH (Spearman's ρ = 0.728, area under the curve = 0.944 > 0.90), with 76.5% sensitivity and 97.2% specificity. CONCLUSIONS: For certain groups of patients likely to achieve DR, additional treatments should not be performed early after surgery. Prolonged follow-up and close observation could help determine the therapeutic effect of surgery and guide postoperative treatments.
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Authors | Zihao Wang, Xiaopeng Guo, Lu Gao, Chenzhe Feng, Wei Lian, Kan Deng, Xinjie Bao, Ming Feng, Renzhi Wang, Bing Xing |
Journal | World neurosurgery
(World Neurosurg)
Vol. 122
Pg. e1137-e1145
(Feb 2019)
ISSN: 1878-8769 [Electronic] United States |
PMID | 30447463
(Publication Type: Journal Article)
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Copyright | Copyright © 2018 Elsevier Inc. All rights reserved. |
Topics |
- Acromegaly
(diagnostic imaging, surgery)
- Adenoma
(diagnostic imaging, surgery)
- Adolescent
- Adult
- Aged
- Child
- Female
- Follow-Up Studies
- Growth Hormone-Secreting Pituitary Adenoma
(diagnostic imaging, surgery)
- Humans
- Male
- Middle Aged
- Remission Induction
- Retrospective Studies
- Sphenoid Bone
(diagnostic imaging, surgery)
- Time Factors
- Treatment Outcome
- Young Adult
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