Related Experiment Videos
Long-term mortality after transsphenoidal surgery and adjunctive therapy for acromegaly
B Swearingen1, F G Barker, L Katznelson
1Neuroendocrine Clinical Center, Department of Surgery, Massachusetts General Hospital, and Harvard Medical School, Boston 02114, USA.
The Journal of Clinical Endocrinology and Metabolism
|October 13, 1998
Summary
Multimodality therapy for acromegaly, including surgery, normalizes survival rates. Successful treatment significantly reduces mortality risk, indicating long-term efficacy of combined therapies for acromegaly patients.
Area of Science:
- Endocrinology
- Neurosurgery
- Oncology
Background:
- Acromegaly, a condition caused by excess growth hormone, is associated with increased mortality.
- Multimodality therapy aims to achieve remission and improve long-term outcomes.
Purpose of the Study:
- To analyze the long-term outcomes of multimodality therapy for acromegaly.
- To assess the impact of treatment on survival rates and mortality risk.
Main Methods:
- Retrospective review of 162 patients undergoing transsphenoidal surgery (1978-1996).
- Long-term follow-up (mean 7.8 years) including biochemical remission assessment (IGF-I, GH suppression).
- Survival analysis using Cox proportional hazards and Poisson regression models, comparing to US population data.
Main Results:
- Overall surgical cure rate was 57% (91% for microadenomas, 48% for macroadenomas), improving over time.
- 83% of patients achieved biochemical remission.
- 10-year recurrence rate was 6% for initially cured patients.
- No significant difference in survival was observed between successfully treated patients and the general population.
- Persistent active disease was associated with a 3.5-fold increased mortality risk.
Conclusions:
- Successful multimodality therapy, including surgery and adjuvant treatments, normalizes survival in acromegaly patients.
- Achieving and maintaining remission is crucial for mitigating the increased mortality risk associated with acromegaly.
- Treatment advancements have improved surgical cure rates over time.