Endocrine Abstracts

Introduction: Acromegaly is a rare disease with significant morbidity and mortality. Surgical treatment is the first line treatment for these patients, with remission rates of >85% for microadenomas and 40–50% for macroadenomas.

Objectives: Our objective was to characterize patients with acromegaly followed in our department and evaluate remission status after surgery. We also aimed to determine remission related factors.

Methods: A retrospective study was performed. Patients diagnosed with acromegaly in the last 12 years and submitted to surgery were included. The following data was collected: age at diagnosis, gender, follow-up period, growth hormone (GH) and insulin-like growth factor 1 (IGF-1) values before and 3–6 months after surgery, adenoma size and invasion of the cavernous sinus, therapeutic strategies and response to therapy.

Results: We included 41 patients. 53.7% (n=22) were female. Mean age at diagnosis was 47.8 years (S.D.=11.9). Mean follow-up was 6 years (S.D.=3.3). Diagnosis was based on phenotypic alterations in the majority of patients (51.2%, n=21). At diagnosis GH value ranged from 0.4 to 80.2 ng/ml (median 11.9) and IGF-1 value ranged from 288 to 1610 ng/ml (median 646). The majority of patients had a macroadenoma (78%, n=32); 36,6% (n=15) had invasion of the cavernous sinus. After surgery, median levels of GH and IGF-1 were 1.9 (min. 0.05, max 37.4) and 333.5 (min. 33.5, max. 1130) respectively. 12.2% (n=5) were submitted to a second surgery and 7.3% (n=3) to radiotherapy. 56.1% (n=23) of the patients were treated with medical therapy after the surgery. During follow-up 1 patient was lost and two patients died. Of the remaining patients 44.7% (n=17) had remission criteria, 31.6% (n=12) had controlled disease under medication and 23.7% (n=9) had active disease. Remission status was significantly correlated with GH value before and after surgery (P=0.016 and P=0.004 respectively) and IGF-1 value after surgery (P<0.001). Invasion of the cavernous sinus was also associated with lower remission frequency (P=0.004).

Conclusion: Remission status after surgery for acromegaly was similar to that described in the literature. The main features correlated with remission were GH value before and after surgery, IGF-1 value after surgery and invasion of the cavernous sinus.