Outcome in acromegaly: A retrospective analysis.

Area of Science:

• Endocrinology
• Neurosurgery
• Oncology

Background:

• Acromegaly treatment in India faces challenges due to high costs and limited availability of recommended therapies.
• There is a significant lack of data on treatment outcomes for Indian acromegaly patients.

Purpose of the Study:

• To analyze treatment modalities and outcomes for acromegaly in a tertiary care hospital in India.
• To evaluate remission rates, recurrence, hypopituitarism, complications, and mortality associated with different treatments.

Main Methods:

• Retrospective analysis of 15 acromegaly patients.
• Remission criteria: nadir growth hormone <1 μg/dl post-Oral Glucose Tolerance Test (OGTT) and normal IGF-1.
• Evaluation of Transsphenoidal Surgery (TSS), Conventional Radiotherapy (CRT), and Cabergoline (CAB).

Main Results:

• All patients had macroadenomas; 33% could not undergo surgery due to refusal or comorbidities.
• TSS achieved 40% remission in operated patients.
• CRT failed in all patients and caused hypopituitarism in 60%.
• Cabergoline achieved 25% remission but showed remarkable symptomatic relief.
• Two patients (14.3%) died due to cerebrovascular accident (CVA).

Conclusions:

• Transsphenoidal surgery is the preferred treatment for acromegaly, but its efficacy is limited in macroadenomas.
• High rates of hypopituitarism are associated with Conventional Radiotherapy.
• Alternative treatments like CRT and Cabergoline have limited efficacy and accessibility issues in India.