The choice of therapy in acromegaly: results of treatment at a tertiary care hospital.
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.
Isidro
Maria Luisa
ML
Department of Endocrinology, Hospital Juan Canalejo, La Coruna, Spain. MA.Luisa.Isidro.San.Juan@sergas.es
Castro
José Antonio
JA
Penín
Manuel
M
Armenta
Jacinto
J
Cordido
Fernando
F
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
D013004:Somatostatin; D007334:Insulin-Like Growth Factor I