Endocrine Abstracts

Introduction: An improvement of survival in patients with acromegaly was claimed in the last years, with multimodal new therapies.

Aims: To assess cure rates of different therapeutic protocols and the impact of these therapies on survival.

Methods: 334 patients (224 F/110 M, mean age 48.1±0.7 years) with acromegaly admitted in a single Neuroendocrinology Department between Jan 2001 and Dec 2013 were retrospectively studied by GH, IGF1 levels at baseline and at final visit, therapy, pituitary failure, and date of the death. PAMCOMP computation program calculated standardized mortality ratio (SMR). Kaplan–Meier curve was used to compare the impact of different therapies on survival. Serum GH levels were measured by IRMA (sensitivity 0.1 ng/ml).

Results: 35.02% patients obtained control of acromegaly: 17.3% were cured after neurosurgery and/or radiotherapy and additionally 17.6% were controlled by medication. Cure rate for surgery was 17.7% (35/197) and 15.03% (23/153) for radiotherapy. 49/128 (33.5%) patients treated by somatostatin receptor analogues (SSA), 8.3% (4/48) treated with dopamine agonist and 6/16 patients (37.5%) treated by GH receptor agonist were adequately controlled. All causes mortality ratio was similar with general population: SMR=1.07 (95% CI 0.70–1.52), average follow-up of 2252.11 person-years (median 6.9 years). Females with last GH above 2 ng/ml had a high SMR=2.51 (95% CI 1.37–4.22).

Operated patients with/without medication and/or radiotherapy had a better survival than untreated patients (rank log Mantel-Cox: P=0.04 operated vs untreated patients, 0.05 operated+SSA patients vs untreated and 0.02 operated+irradiated vs untreated).

Conclusions: Patients with acromegaly and posttreatment GH level ≥2 ng/ml had a high mortality, especially women. Surgery treated patients, with additionally treatment for postoperatory remnants, had a better survival, similar with general population.

Disclosure: This work received financial support through the project ‘CERO – Career profile: Romanian Researcher’, grant number POSDRU/159/1.5/S/135760, cofinanced by the European Social Fund for Sectoral Operational Programme Human Resources De.