title: Clinical features and therapeutic outcomes of patients with acromegaly: single-center experience.
abstract: The aim of this study was to review the outcome of acromegaly treatment, as well as co-morbidity and mortality in a series of patients with acromegaly attending a single center in the last 10 yr. In that period, 53 patients were treated for acromegaly. Transsphenoidal operation was applied as the first-line therapy in 94.3% of patients and it led to disease remission in 59.2% of them. The remission criteria included a nadir GH<1 μg/l after glucose load, and normal age-related IGF-I levels. The remission rate after transsphenoidal surgery was significantly higher in the group of patients with microadenoma (76.9%), than in the group of patients with macroadenoma (52.8%). Patients with invasive tumors had remission rate of 16.7% after transsphenoidal surgery. There were no perioperative deaths. As the second-line treatment somatostatin analogues, radiotherapy, and dopaminergic agonists were used. Hypertension and diabetes were the most frequent co-morbidities in the group of patients. After successful treatment, 30% of patients with diabetes or impaired glucose tolerance had significant improvement of glycemic control. Transsphenoidal surgery is the appropriate firstline therapy in patients with somatotropinoma. Medical and radio-therapy should be reserved as the second-line therapy after surgery failure.
authors.affiliation: Division of Endocrinology, Department of Internal Medicine, University Hospital Center Zagreb, Zagreb University School of Medicine, Kispaticeva 12, 10 000 Zagreb, Croatia. tdusek@mef.hr
authors.forename: T
authors.initials: T
authors.lastname: Dusek
authors.forename: D
authors.initials: D
authors.lastname: Kastelan
authors.forename: A
authors.initials: A
authors.lastname: Melada
authors.forename: M
authors.initials: M
authors.lastname: Baretic
authors.forename: T
authors.initials: T
authors.lastname: Skoric Polovina
authors.forename: Z
authors.initials: Z
authors.lastname: Perkovic
authors.forename: Z
authors.initials: Z
authors.lastname: Giljevic
authors.forename: J
authors.initials: J
authors.lastname: Jelcic
authors.forename: J
authors.initials: J
authors.lastname: Paladino
authors.forename: I
authors.initials: I
authors.lastname: Aganovic
authors.forename: M
authors.initials: M
authors.lastname: Korsic
mesh_terms: D000172:Acromegaly / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery*; D000236:Adenoma / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery*; D000328:Adult; D015331:Cohort Studies; D016208:Databases, Factual; D005260:Female; D005500:Follow-Up Studies; D049912:Growth Hormone-Secreting Pituitary Adenoma / Q000175:diagnosis / Q000453:epidemiology* / Q000601:surgery*; D019382:Human Growth Hormone / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
chemical_list: D019382:Human Growth Hormone