Endocrine Abstracts

Introduction: Acromegaly is a chronical and rare disease which is accompanied by excessive growth hormone (GH) secreting hypohysis tumor. In this study we presented acromegaly patients’ datas who admitted to our center between the years 1998–2016. We discussed patients’ charecteristics and we aimed to investigate the determinants which is effecting the remission rate of the patients’.

Method: 70 acromegaly patients datas were analyzed retrospectively in our center. We evaluated patients’ clinical, laboratory, imaging and treatment modalities informations. The parameters accepted as remission criteria are as follows: 1) Basal GH<2.5 μg/l, 2) Having GH<1 μg/l level after glucose-growth hormone supression test, 3) Having normal IGF-1 (insulin-like growth factor-1) level in accordance with age and gender.

Results: 57.1% of the patients were female. Mean age was 44±12. Mean age was 38±12 when the diagnosis established. 97.1% of the patients had typical acromegaly symptoms. Other findings are: headache (77.1%), sweating (58.6%), vision defect (15.7%), galactorrhea (10%), impotence (10%). Preop GH and IGF-1 levels were 18.3±15.8 μg/l, 954±349 μg/l respectively. 87.1% of the patients had macroadenoma and % 61.4 of the patients had cavernous sinus invasion. Eight of the patients had drug therapy, 62 of them had surgery as first line therapy. 29% of the patients’ pathology reports revealed that GH-Prolactin positive staining. Somatostatine analogues were administered to 64.5% of the patients after surgery. On the 3th month follow up remission rate was 53.5%, on the 12th month remisson rate was 65%, on the late period of the follow up remisson rate was 77.1%. There was statistically significant difference between preop GH levels, adenoma size, cavernous sinus invasion, ki67 proliferation index and remission rate (P<0.05).

Conclusion: We concluded that high preop GH levels, adenoma size, cavernous sinus invasion, high ki67 proliferation index were the determinants of the poor outcome. Besides surgeon experience should take into consideration for better outcome.