Endocrine Abstracts

Aim: To audit the management and treatment outcomes of patients with acromegaly at Royal Devon and Exeter Hospital.

Patients and methods: Hospital case records of 43 patients (21 male), presenting between 1982 and 2004 were reviewed retrospectively. Age at presentation ranged from 21 years to 77 years, with average follow-up being 11.2 years.

Results: 9 (29 percent) of 31 patients had microadenomas at presentation while 22 (71 percent) had macroadenomas. Tumour size is not known in 12 patients. 29 (67 percent) of the 43 patients underwent surgery: 13 patients (30 percent) had surgery alone, 3 patients (7 percent) received surgery and radiotherapy, 4 (9 percent) had surgery and medical therapy and 9 (21 percent) were treated with surgery, radiotherapy and medical therapy in combination. 2 (5 percent) of the 43 received radiotherapy alone, while 4 (9 percent) had a combination of radiotherapy and medical treatment and 5 (12 percent) received medical treatment only. 3 patients (7 percent) refused all treatment. At last follow-up, 16 (40 percent) of 40 patients had achieved nadir growth hormones of < 2 international units per litre after 75-gram oral GTT. 25 (62.5 percent) of 40 achieved nadir levels of < 5. 10 of the 24 IGF-1 levels recorded were in the normal range (42 percent). There were 4 deaths recorded: 2 due to ischaemic heart disease and 2 secondary to colon cancer.

Conclusion: Despite the multiple treatment modalities used in this series of patients, ongoing efforts are required to improve the cure rate.