Unit:
Τομέας Υγείας - Μητέρας - ΠαιδιούLibrary of the School of Health Sciences
Dissertation committee:
Αν. Καθηγητής Παπαδημητρίου Αναστάσιος
Original Title:
Διερεύνηση της μακροχρόνιας εξέλιξης της μεγαλακρίας ανάλογα με τη θεραπευτική αντιμετώπιση
Translated title:
Therapeutic trends and outcome of acromegaly
Summary:
Objective: To evaluate the therapeutic trends and long-term outcome of
treatment modalities for acromegaly in our center over a 40-year period. Design
and Patients: We retrospectively studied 321 acromegalic patients (145
males/176 females) diagnosed and treated from 1970s until September 2013.
Patients were divided into two subgroups: group A consisted of 166 patients
diagnosed before 1990, whereas 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 (96
vs 26 patients respectively, p=0.0001). On the contrary, more patients of group
B were offered surgery (109 vs 70 group A, p=0.0001) and/or medical treatment
(107 vs 39 group A, p=0.0001). On 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.
Keywords:
Acromegaly, Surgery , Pituitary radiation, Medical treatment, Somatostatin analogues
Number of references:
178
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