Mortality in 154 surgically treated patients with acromegaly--a 10-year follow-up survey.
To determine the effects of surgery and adjuvant therapy on the mortality rate of Japanese patients with acromegaly, 154 surgically treated patients were followed until death or December 2000. Mean follow-up period was 10.0 +/- 6.5 (SD) years. Postoperative GH levels, mean values of GH levels measured in the first postoperative month, were <2.5 ng/mL in 73 (47.4%), 2.5-5.0 ng/mL in 50 (32.5%), and >5.0 ng/mL in 31 patients (20.1%). Three of 123 patients with postoperative GH levels <5.0 ng/mL underwent a second transsphenoidal surgery (TSS), the other 120 received no further treatment. Additional treatments, including second TSS, medical treatment, and gamma-knife irradiation for residual tumor, were administered to 25 of 31 patients whose postoperative GH was >5.0 ng/mL. Among the total 154 patients surveyed, 11 (7.1%) died during the follow-up period. The standard mortality ratio (SMR) was 1.17, not different from age- and sex-matched controls. The SMR of the 72 patients with postoperative GH <2.5 ng/mL was better than that of the 51 patients whose postoperative GH was 2.5-5.0 ng/mL (1.09 vs. 1.64); however, the difference was not statistically significant. In conclusion, TSS and adequate adjuvant treatment decreased the excess mortality rate of acromegalics to nearly the same level as that of the general Japanese population.
Arita
Kazunori
K
Department of Neurosurgery, Graduate School of Biomedical Science, Hiroshima University, Hiroshima, 734-8551, Japan.
Kurisu
Kaoru
K
Tominaga
Atushi
A
Eguchi
Kuniki
K
Iida
Koji
K
Uozumi
Tohru
T
Kasagi
Fumiyoshi
F
D000172:Acromegaly / Q000150:complications / Q000401:mortality* / Q000503:physiopathology / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D002423:Cause of Death; D002648:Child; D004702:Endocrine Glands / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006306:Health Surveys; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009994:Osmolar Concentration; D011184:Postoperative Period; D016019:Survival Analysis
D007334:Insulin-Like Growth Factor I