Predictors of postoperative remission of acromegaly. (Experience of the Burdenko Neurosurgical Center)

Astafieva LI, Shkarubo AN, Chernov IV, et al. . Predictors of postoperative remission of acromegaly. (Experience of the Burdenko Neurosurgical Center). Burdenko's Journal of Neurosurgery. 2023;87(6):76‑84. (In Russ., In Engl.)
https://doi.org/10.17116/neiro20238706176

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BACKGROUND

Treatment of acromegaly is still an unresolved problem. Overall postoperative remission rate ranges from 34 to 85%. These values are better for microadenomas (75—90%) and worse for macroadenomas (45—70%). Identification of predictors of acromegaly remission after surgical treatment is an urgent objective to improve the quality of medical care for these patients.

OBJECTIVE

To analyze postoperative freedom from acromegaly and predictors of remission.

MATERIAL AND METHODS

A retrospective single-center study included 227 patients with acromegaly who underwent resection of pituitary adenoma between August 2018 and August 2021.

RESULTS

Remission (normalization of serum IGF-1) was achieved in 65 (55%) patients. Growth hormone and IGF-1 index decreased after surgery in all patients. Mean preoperative serum growth hormone was 12.45 [6.88, 29.85] ng/ml, early postoperative concentration — 1.54 [0.80, 3.38] ng/ml, in delayed period — 1.15 [0.57, 3.80] ng/ml. Mean IGF-1 index was 2.18 [1.69, 2.71], 1.47 [0.99, 1.90] and 0.99 [0.74, 1.43], respectively.

CONCLUSION

Significant predictors of acromegaly remission after neurosurgical treatment were age, preoperative level of growth hormone, tumor size and location, growth hormone and IGF-1 index in early postoperative period and residual tumor after surgery. Multivariate analysis revealed a significant association of acromegaly remission with small tumor size, low postoperative level of growth hormone and no residual tumor within 3—6 month after surgery.

Keywords:

acromegaly

growth hormone

pituitary adenoma

endoscopic transnasal resection of pituitary adenoma

Authors:

Astafieva L.I.

Burdenko Neurosurgical Center

ORCID: 0000-0003-4480-1902

Shkarubo A.N.

Burdenko Neurosurgical Center

ORCID: 0000-0003-3445-3115

Chernov I.V.

Burdenko Neurosurgical Center

ORCID: 0000-0002-9789-3452

Ibrahim S.R.

People’s Friendship University of Russia

ORCID: 0000-0002-6233-9929

Badmaeva I.N.

Burdenko Neurosurgical Center

ORCID: 0000-0003-2211-4298

Strunina Yu.V.

Burdenko Neurosurgical Center

ORCID: 0000-0003-1696-4050

Ilovayskaya I.A.

M.F. Vladimirsky Moscow Regional Research Clinical Institute

ORCID: 0000-0003-3261-7366

Pronin V.S.

Russian Medical Academy of Continuing Professional Education

ORCID: 0000-0001-5045-798X

Sidneva Yu.G.

Burdenko Neurosurgical Center;
Research Institute for Emergency Pediatric Surgery and Traumatology

ORCID: 0000-0003-2733-5874

Kalinin P.L.

Burdenko Neurosurgical Center

ORCID: 0000-0001-9333-9473

Received:

17.06.2023

Accepted:

14.09.2023

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