Predictors for Remission after Transsphenoidal Surgery in Acromegaly: A Dutch Multicenter Study

Eva C Coopmans*, Mark R Postma, Thalijn L C Wolters, Sebastiaan W F van Meyel, Romana Netea-Maier, André P van Beek, Sebastian J C M M Neggers

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

2 Citations (Scopus)
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Abstract

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 after TSS in acromegaly.

Methods: Large multicenter study with retrospective data collection from 3 tertiary neurosurgical referral centers inThe Netherlands. We analyzed clinical data since 2000 from 3 cohorts (Groningen, Nijmegen, and Rotterdam, total n = 282). Multivariate regression models were used to identify predictors of early biochemical remission (12 weeks to 1 year postoperatively) according to the 2010 consensus criteria, long-term remission (age- and sex-normalized insulin-like growth factor 1 [IGF-1] and the absence of postoperative treatment until last follow-up), and relative IGF-1 and growth hormone [GH] reduction.

Results: A larger maximum tumor diameter (odds ratio [OR] 0.91, 95% CI 0.87-0.96, P = .0001) was associated with a lower chance of early biochemical remission. A larger maximum tumor diameter (OR 0.93, 95% CI 0.89-0.97, P = .0022) and a higher random GH concentration at diagnosis (OR 0.98, 95% CI 0.96-0.99, P = .0053) were associated with a lower chance of long-term remission.

Conclusion: Maximum tumor diameter and random GH concentration at diagnosis are the best predictors for remission after TSS in acromegaly.

Original languageEnglish
Pages (from-to)1783-1792
Number of pages10
JournalJournal of Clinical Endocrinology and Metabolism
Volume106
Issue number6
Early online date5-Feb-2021
DOIs
Publication statusPublished - Jun-2021

Keywords

  • acromegaly
  • transsphenoidal surgery
  • remission
  • PREOPERATIVE SOMATOSTATIN ANALOGS
  • CRITERIA
  • METAANALYSIS
  • CONSENSUS
  • GROWTH
  • CURE

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