Fluctuation analysis of postoperative secretory status in patients operated for acromegaly |
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| Affiliation: | 1. Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada;2. Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Ontario, Canada;3. Department of Surgery, University of Toronto, Toronto, Ontario, Canada;4. Program in Developmental and Stem Cell Biology, Hospital for Sick Children, Toronto, Ontario, Canada;5. Department of Orthopaedic Surgery, Duke University, Durham, NC, USA;1. From the Ankara University Faculty of Medicine, Department of Endocrinology and Metabolism, Ankara, Turkey.;1. Centre for Evaluation and Information on Pharmacodependence-Addictovigilance (CEIP-A) of Nancy, Nancy University Medical Center, Nancy, France;2. Poison Information and Toxicovigilance Center, Nancy University Medical Center, Nancy, France;3. Department of Cardiology, Nancy University Medical Centre, Nancy, France;4. Department of Psychiatry and Clinical Psychology, Nancy University Medical Centre, Université de Lorraine, France |
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| Abstract: | ObjectiveThe aim of this study was to describe endocrinological outcome in patients operated on for acromegaly.MethodsA retrospective study included 167 patients. Patients were assessed in the early postoperative period (EPP), at 3 months (M3), at 1 year (Y1), and then annually. They were classified as grade I (IGF-1 level normal-for-age and positive GH response on oral glucose tolerance test [nadir <0.4 ng/L]); grade II (discordant); or grade III or IV (acromegaly, controlled or uncontrolled under medical therapy, respectively).ResultsTaking all patients with all grades, 35% changed grades between EPP and M3, 26% between M3 and Y1 and 9% after Y1. In grade I, respectively 22%, 15% and 2% of patients changed grades between EPP and M3, between M3 and Y1, and after Y1, compared to 31%, 6% and 6% in grade IV. Respectively 57%, 67%, and 47% of grade II patients changed grades between EPP and M3, between M3 and Y1, and after Y1; between EPP or M3 and last follow-up (>1 year), respectively 74% and 75% of grade II patients changed grades. Knosp category, resection quality and abnormal GH response (vs. abnormal IGF-1) significantly impacted grade II patients’ outcome.ConclusionsWhereas outcome in grades I and III–IV seems to be determined by 1 year, grade II discordant patients’ outcome remains uncertain even after 1 year. |
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| Keywords: | Acromegaly Classification GH IGF-1 Recurrence Outcome Acromégalie Classification Hormone de croissance IGF-1 Récidive Pronostic |
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