Multidisciplinary Approach for Acromegaly: A Single Tertiary Center's Experience

Haliloğlu, Özlem; Kuruoğlu, Enis; Özkaya, Hande Mefkure; Keskin, Fatma Ela; Günaldı, Ömür; Öz, Büğe; Gazioğlu, Nurperi; Kadıoğlu, Pınar; Tanrıöver, Necmettin

doi:10.1016/j.wneu.2015.12.092

Cited by 20 publications

(13 citation statements)

References 31 publications

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“…In the present study, about 40% of the patients achieved remission three months post-surgery even though more than 90% of the tumors were macroadenomas. Haliloglu et al (3) in a series of 103 patients and Babu et al (14) in a series of 58 patients reported 51.5% and 69% of early remission, respectively.…”

Section: Discussionmentioning

confidence: 90%

“…Surgical resection is the first-line option for treating the adenomas, with the remission rate of 85% for microadenomas and 40% - 50% for macroadenomas at experienced centers (3). In case of surgical treatment failure, the accepted second-line therapy includes medical therapy with somatostatin analogs (SSA), GH receptor antagonists, and/or dopamine agonists (DAs) such as Cabergoline (4, 5).…”

Section: Introductionmentioning

confidence: 99%

“…Studies have investigated some clinical parameters such as age, gender, tumor size, local invasiveness, and presurgical GH levels, obtaining controversial results (3, 8, 9). The nuclear antigen Ki-67, measured by an antibody called MIB-1, recognizes the proliferative activity of the cells (10).…”

Section: Introductionmentioning

confidence: 99%

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Associations of Ki-67 Labeling Index with Clinical and Paraclinical Features of Growth Hormone-Secreting Pituitary Adenomas: A Single Center Report from Iran

Mohseni

Aboeerad

Sharifi

et al. 2019

Int J Endocrinol Metab

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Background Acromegaly is a rare disorder resulting from benign growth hormone (GH)-secreting pituitary adenomas in 90% of the cases. In recent years, many researchers have studied the Ki-67 index level of pituitary tumors and its relationship with demographics, biochemical parameters, clinical behavior, and recurrence rate. Objectives This study aimed to evaluate the correlation of Ki-67 index level with clinicoradiological and endocrinological parameters in confirmed GH-secreting pituitary adenomas, as well as with the surgical response and medical treatment after surgery. Methods We collected the medical and pathologic records of 49 patients with GH-secreting pituitary adenoma who underwent surgeries from 2008 to 2017 in Shariati hospital affiliated to Tehran University of Medical Sciences. Results According to MRI reports, 94% of the tumors were macroadenomas. The MRI findings also revealed the median maximal adenoma diameter of 18.5 mm. About 40% of the patients achieved remission three months after the surgery. Younger patients had a significantly higher Ki-67 index level (P = 0.036). We did not observe any significant difference in the Ki-67 index level regarding gender, tumor type, maximal tumor diameter, tumor invasiveness, tumor secretory type, and remission. Interestingly, the Ki-67 index level was negatively correlated with the insulin-like growth factor-1 (IGF-1) level at the last follow-up (P = 0.02). In logistic regression analysis, patients with higher preoperative GH serum levels had a better outcome. Conclusions Our results indicated a negative correlation between age and Ki-67 index level. However, there was no association between the Ki-67 index level and some tumor behaviors, as well as short- and long-term remission.

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Section: Discussionmentioning

confidence: 90%

Section: Introductionmentioning

confidence: 99%

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Associations of Ki-67 Labeling Index with Clinical and Paraclinical Features of Growth Hormone-Secreting Pituitary Adenomas: A Single Center Report from Iran

Mohseni

Aboeerad

Sharifi

et al. 2019

Int J Endocrinol Metab

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“…For the final quantitative analysis, 52 case series, comprising a total of 4,375 patients, were included. Of these series, 36 were microsurgical [12, 22–57] and 13 were endoscopic, [11, 13–18, 58–63], comprising 3,144 and 940 patients, respectively (Figure 1). Three studies compared microsurgical and endoscopic approaches, comprising 111 and 180 patients, respectively.…”

Section: Resultsmentioning

confidence: 99%

Microsurgical versus endoscopic transsphenoidal resection for acromegaly: a systematic review of outcomes and complications

et al. 2017

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“…According to Knosp classifications of pituitary adenomas, tumor size (TS) and their suprasellar extension (SSE) have been used for preoperative planning, prediction of possible outcomes, and the evaluation of surgical outcomes. Although there is no clear evidence that these classifications are associated with tumor resection and remission rates, studies are suggesting this is the case [ 6 , 16 , 18 , 23 , 25 , 26 ].…”

Section: Introductionmentioning

confidence: 99%

Results of Endoscopic Surgery in Patients with Pituitary Adenomas : Association of Tumor Classification Grades with Resection, Remission, and Complication Rates

Erkan

Barut

Akbaş

et al. 2021

J Korean Neurosurg Soc

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The endoscopic endonasal transsphenoidal approach is a widely-used method for the surgical treatment of pituitary adenomas. We aimed to evaluate the results of endoscopic surgery by comparing preoperative classification methods and investigating their relationship with postoperative resection and remission rates and complications. Methods : We retrospectively reviewed the medical records of 236 patients (118 males) who underwent surgery for pituitary adenomas. Preoperative Knosp classification, tumor size (TS), suprasellar extension (SSE), postoperative resection and remission rates, and complications were evaluated. Results : The follow-up period was 3 months to 6 years. The patients' ages ranged between 16 and 84 years. Endocrinologically, 114 patients (48.3%) had functional adenoma (FA), and 122 patients (51.7%) had non-functional adenoma (NFA). Among the FA group, 92 (80.7%) showed remission. A statistically significant difference was found between patients with and without remission in terms of the Knosp, TS, and SSE classifications (p<0.01). Knosp, TS, and SSE classification grades were found to be correlated with the resection rates (p<0.01). Meningitis was seen in seven patients (3.0%), diabetes insipidus in 16 (6.9%; permanently in two [0.9%]), and rhinorrhea in 19 (8.1%). Thirty-six patients (15.3%) developed pituitary insufficiency and received hormone replacement therapy. Conclusion :The resection categories and remission rates of FAs were directly proportional to the adenoma sizes and Knosp grades, while the degree of suprasellar growth further complicated resection and remission rates. Adenoma sizes less than 2 cm and SSEs less than 1 cm are associated with favorable remission and resection rates.

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Multidisciplinary Approach for Acromegaly: A Single Tertiary Center's Experience

Cited by 20 publications

References 31 publications

Associations of Ki-67 Labeling Index with Clinical and Paraclinical Features of Growth Hormone-Secreting Pituitary Adenomas: A Single Center Report from Iran

Associations of Ki-67 Labeling Index with Clinical and Paraclinical Features of Growth Hormone-Secreting Pituitary Adenomas: A Single Center Report from Iran

Microsurgical versus endoscopic transsphenoidal resection for acromegaly: a systematic review of outcomes and complications

Results of Endoscopic Surgery in Patients with Pituitary Adenomas : Association of Tumor Classification Grades with Resection, Remission, and Complication Rates

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