ECE2020 Audio ePoster Presentations Pituitary and Neuroendocrinology (217 abstracts)
Predictors for remission after transsphenoidal surgery in acromegaly: A dutch multicenter study
Eva Coopmans 1 , Mark Postma 2 , Thalijn Wolters 3 , Sebastiaan van Meyel 1 , Romana Teodora Netea-Maier 3 , Sebastian Neggers 1 & Andre van Beek 2
1Erasmus University Medical Center Rotterdam, Department of Medicine, Endocrinology section, Pituitary Center Rotterdam, Rotterdam, Netherlands; 2University Medical Center Groningen, Department of Endocrinology, Groningen, Netherlands; 3Radboud University Medical Center, Division of Endocrinology, Department of Internal Medicine, Nijmegen, Netherlands
Context: Transsphenoidal surgery (TSS) is the primary treatment of choice in acromegaly. It is important to identify patients in whom surgical cure is not attainable at an early stage, both to inform patients on expected treatment outcome and to select those who are more likely to need additional therapy.
Objective: To identify predictors for remission and relapse after TSS in acromegaly.
Design: Retrospective study in three large tertiary neurosurgical referral centers in the Netherlands.
Methods: We analyzed clinical data since 2000 from three cohorts (Rotterdam, Groningen and Nijmegen, total n = 282). Multivariate regression models were used to identify predictors of early biochemical remission (12 weeks-1 year postoperatively) according to the 2010 consensus criteria, long-term clinical remission (no additional treatment applied at last follow-up) and relative GH and IGF-1 reduction.
Results: The presence of a macroadenoma (vs. microadenoma, OR = 0.17, [0.09 – 0.34], P ≤ 0.0001) was associated with a lower chance of early biochemical remission. A lower random GH concentration at diagnosis (OR = 0.98, [0.97 – 0.99], P = 0.0058) was associated with a higher chance of long-term clinical remission, while cavernous sinus invasion (OR = 0.35, [0.16 – 0.77], P = 0.0097) and the presence of a macroadenoma (OR = 0.43, [0.20 – 0.93], P = 0.0321) were associated with a lower chance of long-term clinical remission. Higher GH and IGF-1 concentration at diagnosis were associated with more relative IGF-1 reduction (ß = 8.90, SE = 1.59, P ≤ 0.0001; ß = −0.22, SE = 0.05, P ≤ 0.0001, respectively).
Conclusion: Tumor size, GH concentration at diagnosis and cavernous sinus invasion are the best predictors for remission after transsphenoidal surgery in acromegaly.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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