ECE2009 Poster Presentations Endocrine tumours and neoplasia (53 abstracts)
Acromegaly in the Swedish pituitary register: background data and up to 10 years follow-up
Britt Edén Engström 1 , Margareta Bramnert 2 , Bertil Ekman 3 , Charlotte Höybye 4 , Anders Karlsson 1 , Cecilia Mattsson 5 , Thord Rosén 6 , Stig Valdemarsson 7 & Sigbritt Werner 8
1Uppsala University Hospital, Uppsala, Sweden; 2Malmö University Hospital, Malmö, Sweden; 3Linköping University Hospital, Linköping, Sweden; 4Karolinska University Hospital, Solna, Sweden; 5Umeå University Hospital, Umeå, Sweden; 6Sahlgrenska University Hospital, Göteborg, Sweden; 7Lund University Hospital, Lund, Sweden; 8Karolinska University Hospital, Huddinge, Sweden.
Background: The aim of the Swedish Pituitary Register – the Swedish Pituitary Study Group’s quality register – is to guarantee that all patients with pituitary tumours get equivalent diagnostic evaluation and treatment, as well as to evaluate given therapy. In this study, patients diagnosed with acromegaly from 1991 are described.
Methods: Data from 557 patients (275 men/282 women), median age 51 years (range 4–87), with acromegaly were registered.
Results: The incidence 1991–2007 was 3, 7 cases/million per year. Thirty-eight percent were classified as micro- and 58% as macroadenomas. According to SIPAP classification system for tumour extension 44% had suprasellar, 27% infrasellar, 28% parasellar, 6% anterior and 6% posterior extension. Twenty-one percent had visual field defects and 13% impaired visual acuity. Pre-operatively LH/FSH, ACTH, TSH and ADH deficiencies were reported in 21, 6, 7 and 1%. Four hundred and three patients were operated once, and 47 patients 2–3 times. Fractionated radiotherapy was given to 28 patients and treatment with Gamma Knife to 44 patients. One hundred and seventy-one patients received medical treatment. Follow-ups after 1, 5 and 10 years were registered for 91, 75 and 51%. The overall cure rate (normal IGF-1 for age and mean GH<5 mU/l or 2.5 μg/l) after 1, 5 and 10 years was 42, 51 and 62%. Improvement was reported in 44, 36 and 24%. Of these, further 31, 54 and 58% normalized their GH- and IGF-1 values on medical treatment. After 1, 5 and 10 years, 51, 58 and 68% of cases with primary surgery were cured, and well controlled in further 9, 17 and 11%.
Conclusion: Baseline registration appeared to be complete and treatment in accordance to international guidelines. Number of cured patients seemed to increase over time. Further efforts will be made to increase the frequency of follow-up registrations also after long time.
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Endocrine Abstracts
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