title: Therapeutic trends and outcome of acromegaly: a single center experience over a 40-year period.
abstract: OBJECTIVE
  To evaluate the therapeutic trends and long-term outcome of treatment modalities for acromegaly in our center over a 40-year period.
  
  
  METHODS
  We retrospectively studied 321 acromegalic patients (145 males/176 females) diagnosed and treated from the 1970s until September 2013. Patients were divided into two subgroups: group A consisted of 166 patients diagnosed before 1990 and group B of 155 patients diagnosed after 1990. Outcome was assessed with GH (random and/or post OGTT) and IGF1 measurements.
  
  
  RESULTS
  More group A than group B patients were submitted to radiotherapy (57.8% vs 16.8% patients, respectively, p <0.001). In contrast, more patients of group B were offered surgery (70.3% vs 42.1% in group A, p <0.001) and/or medical treatment (70.3% vs 23.4% in group A, p <0.001). At latest follow-up, 68.4 % of patients in group B achieved GH <2.5 μg/l after treatment vs 39.8% in group A, p=0.001, 46.9% of patients in group B achieved GH <1 μg/l vs 20.3% in group A, p=0.001 and 47.1% of patients in group B achieved during OGTT GH nadir <0.4 μg/l vs 18.6% in group A, p=0.001.
  
  
  CONCLUSIONS
  Transsphenoidal resection and medical treatment resulted in improved outcome in acromegalic patients treated over the last 20 years. However, the disease still remains uncontrolled in a considerable number of patients.
authors.affiliation: Department of Endocrinology Diabetes and Metabolism, "Evaggelismos" Hospital, Athens, Greece.
authors.forename: Olga
authors.initials: O
authors.lastname: Karapanou
authors.affiliation: Department of Endocrinology Diabetes and Metabolism, "Evaggelismos" Hospital, Athens, Greece.
authors.forename: Marinella
authors.initials: M
authors.lastname: Tzanela
authors.affiliation: Department of Endocrinology Diabetes and Metabolism, "Evaggelismos" Hospital, Athens, Greece.
authors.forename: Marietta
authors.initials: M
authors.lastname: Christoforaki
authors.affiliation: Department of Endocrinology Diabetes and Metabolism, "Evaggelismos" Hospital, Athens, Greece.
authors.forename: Lida
authors.initials: L
authors.lastname: Papastathopoulou
authors.affiliation: Department of Endocrinology Diabetes and Metabolism, "Evaggelismos" Hospital, Athens, Greece.
authors.forename: Paraskevi
authors.initials: P
authors.lastname: Moutsatsou
authors.affiliation: Department of Endocrinology Diabetes and Metabolism, "Evaggelismos" Hospital, Athens, Greece.
authors.forename: Efi
authors.initials: E
authors.lastname: Botoula
authors.affiliation: Department of Endocrinology Diabetes and Metabolism, "Evaggelismos" Hospital, Athens, Greece. stsagara@otenet.gr.
authors.forename: Stylianos
authors.initials: S
authors.lastname: Tsagarakis
mesh_terms: D000172:Acromegaly / Q000097:blood / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D000236:Adenoma / Q000097:blood / Q000150:complications / Q000378:metabolism / Q000628:therapy*; D000328:Adult; D015415:Biomarkers / Q000097:blood; D057210:Delayed Diagnosis; D005260:Female; D006115:Greece; D049912:Growth Hormone-Secreting Pituitary Adenoma / Q000097:blood / Q000150:complications / Q000378:metabolism / Q000628:therapy*; D020249:Hormone Replacement Therapy / Q000009:adverse effects; D019382:Human Growth Hormone / Q000009:adverse effects / Q000097:blood / Q000378:metabolism / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010902:Pituitary Gland / Q000187:drug effects* / Q000378:metabolism / Q000601:surgery*; D010910:Pituitary Irradiation / Q000009:adverse effects; D011237:Predictive Value of Tests; D012074:Remission Induction; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D019382:Human Growth Hormone