The Dose of Somatostatin Analogues during Pre-Surgical Treatment Is a Key Factor to Achieve Surgical Remission in Acromegaly
Abstract
:1. Introduction
2. Materials and Methods
2.1. Patients
2.2. Assays and Remission Criteria
2.3. Clinical Definitions
2.4. Radiological Assessment
2.5. Surgical Procedure and Histological Analysis
2.6. Statistical Analysis
3. Results
3.1. Baseline Characteristics
3.2. Surgical Remission (2010 Criteria)
3.3. Surgical and Endocrine Complications and Tumour Consistency
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Variable | Untreated (n = 28) | Pre-Treated (n = 20) | p Value * |
---|---|---|---|
Age (years) | 49.6 ± 2.3 | 52.2 ± 3.2 | 0.511 |
Female sex | 64.3% (n = 18) | 70 % (n = 14) | 0.679 |
Diabetes | 10.7% (n = 3) | 30.0% (n = 6) | 0.091 |
Hypertension | 35.7% (n = 10) | 45.0% (n = 9) | 0.517 |
Heart disease | 10.7% (n = 3) | 5.0% (n = 1) | 0.480 |
Obesity | 14.3% (n = 4) | 10.0% (n = 2) | 0.658 |
Sleep apnoea syndrome | 21.4% (n = 6) | 25.0% (n = 5) | 0.772 |
Pituitary apoplexy | 3.6% (n = 1) | 0.0% (n = 0) | 0.333 |
Visual involvement | 17.9% (n = 5) | 0.0% (n = 0) | 0.046 |
Headache | 32.1% (n = 9) | 5.0% (n = 1) | 0.022 |
Hypopituitarism | 21.4% (n = 6) | 15.0% (n = 3) | 0.574 |
Presurgical GH (ng/mL) | 12.3 ± 3.1 | 10.5 ± 1.9 | 0.664 |
Presurgical IGF1 (ng/mL) | 653.2 ± 58.0 | 686.5 ± 67.7 | 0.711 |
Macroadenoma | 82.1% (n = 23) | 85.0% (n = 17) | 0.793 |
Tumour size (mm) | 16.1 ± 1.7 | 14.3 ± 1.7 | 0.451 |
Knosp grade 3–4 | 39.3% (n = 11) | 20.0% (n = 4) | 0.098 |
Patients | 2010 Criteria | |||
---|---|---|---|---|
Pretreated | Untreated | P | Odds Ratio, 95% CI | |
All patients (n = 48) | 60.0% (n = 12) | 50.0% (n = 14) | 0.493 | OR = 1.50 [0.47–4.79] |
Microadenomas (n = 8) | 100% (n = 3) | 80% (n = 4) | 0.408 | NC |
Macroadenomas (n = 40) | 52.9% (n = 9) | 43.5% (n = 10) | 0.554 | OR = 1.46 [0.41–5.15] |
Knosp 2–3 pituitary adenomas (n = 16) | 0.0% (n = 0) | 18.2% (n = 2) | 0.360 | NC |
All patients considering high SSAs dose (n = 48) | 78.6% (n = 11/14) | 44.1% (n = 15/34) | 0.029 | OR = 4.64 [1.09–19.7] |
Macroadenomas considering high SSAs dose (n = 40) | 72.7% (n = 8/11) | 37.9% (n = 11/29) | 0.049 | OR = 4.39 [0.95–20.03] |
All patients considering treatment ≥ 6 months with SSA (n = 48) | 63.6% (n = 7/11) | 51.4% (n = 19/37) | 0.473 | OR = 1.66 [0.41–6.64] |
Macroadenomas considering treatment ≥ 6 months with SSA (n = 40) | 55.6% (n = 5/9) | 45.2% (n = 14/31) | 0.583 | OR = 1.52 [0.34–6.76] |
All patients considering treatment with lanreotide (n = 48) | 71.4% (n = 10/14) | 47.1% (n = 16/34) | 0.124 | OR = 0.38 [0.06–2.28] |
Macroadenomas considering treatment with lanreotide (n = 40) | 63.6% (n = 7/11) | 41.4% (n = 12/29) | 0.208 | OR = 0.5 [0.08–3.10] |
All patients considering treatment with octreotide (n = 48) | 33.3% (n = 2/6) | 57.1% (n = 24/42) | 0.274 | OR = 2.81 [0.74–10.75] |
Macroadenomas considering treatment with octreotide (n = 40) | 33.3% (n = 2/6) | 50.0% (n = 17/34) | 0.451 | OR = 2.48 [0.59–10.40] |
Variable | Pre-Treated (n = 20) | Untreated (n = 28) | p Value |
---|---|---|---|
Surgical complications | 15.0% (n = 3) | 21.4% (n = 6) | 0.574 |
New APD | 38.9% (n = 7) | 42.9% (n = 9) | 0.802 |
Diabetes insipidus * | 15.0% (n = 3) | 21.4% (n = 6) | 0.574 |
Hospitalization length stay | 6.7 ± 2.0 | 6.9 ± 1.4 | 0.937 |
Hard tumours | 15.0% (n=3) | 28.6% (n = 8) | 0.270 |
Variable | Pre-treated with High Doses (n = 14) | Untreated or low doses (n = 34) | p Value |
Surgical complications | 14.3% (n = 2) | 20.6% (n = 7) | 0.611 |
New APD | 25.0% (n = 3) | 48.2% (n = 13) | 0.175 |
Diabetes insipidus | 21.4% (n = 3) | 17.7% (n = 6) | 0.760 |
Hospitalization length stay | 7.46 ± 10.6 | 6.5 ± 6.20 | 0.711 |
Hard tumours | 7.1% (n = 1) | 29.4% (n = 10) | 0.095 |
Variable | Pre-treated >6 Months | Untreated or Pre-treated <6 Months | p Value |
Surgical complications | 18.2% (n = 2) | 18.9% (n = 7) | 0.956 |
New APD | 33.3% (n = 3) | 43.3% (n = 13) | 0.593 |
Diabetes insipidus | 18.2% (n = 2) | 18.9% (n = 7) | 0.956 |
Hospitalization length stay | 7.0 ± 10.99 | 6.72 ± 6.38 | 0.918 |
Hard tumours | 18.2% (n = 2) | 24.3% (n = 9) | 0.670 |
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Araujo-Castro, M.; Pascual-Corrales, E.; Pian, H.; Ruz-Caracuel, I.; Acitores Cancela, A.; Duque, S.G.; Berrocal, V.R. The Dose of Somatostatin Analogues during Pre-Surgical Treatment Is a Key Factor to Achieve Surgical Remission in Acromegaly. Endocrines 2021, 2, 241-250. https://doi.org/10.3390/endocrines2030023
Araujo-Castro M, Pascual-Corrales E, Pian H, Ruz-Caracuel I, Acitores Cancela A, Duque SG, Berrocal VR. The Dose of Somatostatin Analogues during Pre-Surgical Treatment Is a Key Factor to Achieve Surgical Remission in Acromegaly. Endocrines. 2021; 2(3):241-250. https://doi.org/10.3390/endocrines2030023
Chicago/Turabian StyleAraujo-Castro, Marta, Eider Pascual-Corrales, Héctor Pian, Ignacio Ruz-Caracuel, Alberto Acitores Cancela, Sara García Duque, and Víctor Rodríguez Berrocal. 2021. "The Dose of Somatostatin Analogues during Pre-Surgical Treatment Is a Key Factor to Achieve Surgical Remission in Acromegaly" Endocrines 2, no. 3: 241-250. https://doi.org/10.3390/endocrines2030023