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[Predictors of postoperative remission of acromegaly. (Experience of the Burdenko Neurosurgical Center)].

Authors :
Astafyeva LI
Shkarubo AN
Chernov IV
Ibrahim SR
Badmaeva IN
Strunina YV
Ilovayskaya IA
Pronin VS
Sidneva YG
Kalinin PL
Source :
Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko [Zh Vopr Neirokhir Im N N Burdenko] 2023; Vol. 87 (6), pp. 76-84.
Publication Year :
2023

Abstract

Background: Treatment of acromegaly is still an unresolved problem. Overall postoperative remission rate ranges from 34 to 85%. These values are better for microadenomas (75-90%) and worse for macroadenomas (45-70%). Identification of predictors of acromegaly remission after surgical treatment is an urgent objective to improve the quality of medical care for these patients.<br />Objective: To analyze postoperative freedom from acromegaly and predictors of remission.<br />Material and Methods: A retrospective single-center study included 227 patients with acromegaly who underwent resection of pituitary adenoma between August 2018 and August 2021.<br />Results: Remission (normalization of serum IGF-1) was achieved in 65 (55%) patients. Growth hormone and IGF-1 index decreased after surgery in all patients. Mean preoperative serum growth hormone was 12.45 [6.88, 29.85] ng/ml, early postoperative concentration - 1.54 [0.80, 3.38] ng/ml, in delayed period - 1.15 [0.57, 3.80] ng/ml. Mean IGF-1 index was 2.18 [1.69, 2.71], 1.47 [0.99, 1.90] and 0.99 [0.74, 1.43], respectively.<br />Conclusion: Significant predictors of acromegaly remission after neurosurgical treatment were age, preoperative level of growth hormone, tumor size and location, growth hormone and IGF-1 index in early postoperative period and residual tumor after surgery. Multivariate analysis revealed a significant association of acromegaly remission with small tumor size, low postoperative level of growth hormone and no residual tumor within 3-6 month after surgery.

Details

Language :
English; Russian
ISSN :
0042-8817
Volume :
87
Issue :
6
Database :
MEDLINE
Journal :
Zhurnal voprosy neirokhirurgii imeni N. N. Burdenko
Publication Type :
Academic Journal
Accession number :
38054230
Full Text :
https://doi.org/10.17116/neiro20238706176