Endocrine Abstracts

Introduction: Data on transsphenoidal surgery (TSS) and effect of somatostatin analog therapy (SSA) in acromegaly different among medical centers. We analyzed the data on TSS, SSA and their combination in acromegalic patients of Moscow region.

Design: In this study 117 acromegalic patients (25 males and 92 females, 55.0 (IQR 44 – 62) years) were eligible for participation, of whom 34 were newly-diagnosed aromegaly (NA group) (macroadenoma (macro)- 80%), 35 primary treated with SSA group (macro −60%), 29 after TSS group, (macro −73%), 19 SSA after TSS (macro – 95%). In 34 NA patients we assessed efficiency after 6 months of SSA (23 patients) (macro −78%) and TSS (10 patients) (macro −70%). We also assessed efficiency of SSA therapy after 6 months in 10 patients (macro −100%) without control of acromegaly after TSS (SSA+TSS).

Results: In micro adenoma cases number of patients with controlled phase of acromegaly was comparable between TSS and SSA groups (47% and 43%). In macro adenoma cases controlled phase of acromegaly was greater in TSS and TSS+SSA groups in compare with SSA group (43%, 40 and 35% accordingly). Among NA patients, who started treatment of SSA or underwent TSS the %ULN of IGF-1 greater decreased in TSS group than in SSA group (P<0.05) (from 172 (83.7–238.1) to −22.6 (−36.7–23.7)% (P<0.05) and from 227 (136–342)% to 30.7 (3.0–118.4)%, accordingly, (P<0.05)). In group TSS+SSA the %ULN of IGF-1 decreased from 158.5 (53.7–215.8)% to 1.4 (−11.7–34.5)% accordingly, (P<0.05). The controlled phase of acromegaly in macro- and micro adenoma cases was reached in 40% and 50% after primary SSA treatment, in 57% and 100% after primary TSS, accordingly, and in 50% in SSA + TSS.

Conclusion: The primary TSS lowered IGF1 values more efficiently and allowed to reach control of disease in compare with primary SSA treatment, especially in macro adenoma cases in acromegalic patients.