ECE2015 Eposter Presentations Pituitary: clinical (121 abstracts)
Clinical features and treatment outcomes of resistant acromegaly patients: a single-centre study
Özgür Demir , Asena Gökçay Canpolat , Berna Imge Aydoğan , Çağlar Keskin , Şule Canlar , Mustafa Şahin , Rifat Emral , Sevim Güllü , Vedia Tonyukuk Gedik , Ali Riza Uysal & Demet Çorapçioğlu
Department of Endocrinology and Matabolism, Ankara University Faculty of Medicine, Ankara, Turkey.
Introduction: Disease control in acromegaly can be achieved by surgery, medical treatment, and radiotherapy either alone or in combination. The acromegaly patients whom tumour shrinkage cannot be provided or growth hormone levels do not decrease under multiple treatment modalities are designated as resistant acromegaly. We aimed in our study to evaluate the clinical features of resistant acromegaly patients and determine their responds to different treatment modalities.
Methods and results: 47 acromegaly patients were enrolled between 2007 and 2015 in this study. 18 of patients (ten men and eight women) were accepted as resistant acromegaly according to their clinical course. The median age, median tumour size and mean IGF1 levels at diagnosis were found 36.5 (28–62), 21 mm (12–70), and 1184±567 ng/ml respectively. The mean numbers of their operation and radiation were found 2 (0–3) and 1 (0–1). Of these 18 procedures, 15 were transsphenoidal procedures and three involved transfrontal surgery. Histological evaluation revealed exhibition of sparse granular staining in eight patients. Long acting somatostatin analogue therapy dose was increased in three patients. Cabergoline (0.5–2 mg/week) and pegvisomant therapy were added to their somatostatin analogue therapy in five and ten patients respectively. The mean follow-up was 18±4 months. There were no difference found between these tree treatment modalities. IGF1 normalisation was achieved overall in 94% of resistant acromegaly patients.
Discussion: Resistance to traditional treatment options in acromegaly represents 25% of whole cases. We found a similar ratio as 39% in our case series. Resistant group was found to be diagnosed at younger age, with greater dimensions of tumour and found to have more sparse granular staining compatible with literature. We could not find any differences between IGF1 levels. It is also a debate as whether which treatment option is suitable for resistant patients.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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