title: The choice of therapy in acromegaly: results of treatment at a tertiary care hospital.
abstract: OBJECTIVE
  The aim of our study was to investigate the characteristics of acromegalic patients diagnosed at a tertiary University Hospital and to evaluate the results of the recommended treatment protocols.
  
  
  METHODS
  All our acromegalic patients were included (n=48; 27 women). Demographic, hormonal, visual and imaging data at diagnosis and during follow-up were recorded, as well as the treatments applied.
  
  
  RESULTS
  In 73.0% of the patients, acromegaly was due to a pituitary macroadenoma. From those under periodic surveillance, 68.2% underwent surgery and 36.4% had radiotherapy. At the time of the study 88.6% of the patients were receiving medical therapy, 28.2% of them as first-line treatment. Applying current criteria, only one patient was cured by surgery. Considering normal age and sex-matched concentrations of IGF-I as a control criteria, surgery resulted in disease control in 10% of the patients who had surgery, while medical treatment controlled the disease in 76.9% (P <0.05). Of those who receive medical therapy as first-line treatment, tumour size decreased in 45.5%, while in the rest no significant changes were observed during follow-up.
  
  
  CONCLUSIONS
  Not all centres obtain the results reported in the literature in terms of disease control and morbidity after surgical treatment of growth hormone-secreting tumours. It is possible that in some hospitals first-line medical treatment should be chosen, unless the patient has visual disturbances, as long as it is not clear that partial surgical removal of the tumour significantly improves response to medical therapy or reduces its costs.
authors.affiliation: Department of Endocrinology, Hospital Juan Canalejo, La Coruna, Spain. MA.Luisa.Isidro.San.Juan@sergas.es
authors.forename: Maria Luisa
authors.initials: ML
authors.lastname: Isidro
authors.forename: José Antonio
authors.initials: JA
authors.lastname: Castro
authors.forename: Manuel
authors.initials: M
authors.lastname: Penín
authors.forename: Jacinto
authors.initials: J
authors.lastname: Armenta
authors.forename: Fernando
authors.initials: F
authors.lastname: Cordido
mesh_terms: D000172:Acromegaly / Q000097:blood / Q000209:etiology / Q000628:therapy*; D000236:Adenoma / Q000150:complications* / Q000532:radiotherapy / Q000601:surgery; D000328:Adult; D000368:Aged; D005500:Follow-Up Studies; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000032:analysis*; D008297:Male; D008875:Middle Aged; D010911:Pituitary Neoplasms / Q000150:complications* / Q000532:radiotherapy / Q000601:surgery; D013004:Somatostatin / Q000031:analogs & derivatives / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D013004:Somatostatin; D007334:Insulin-Like Growth Factor I