Presurgical somatostatin receptor ligand treatment does not affect tumor consistency in GH-secreting pituitary macroadenomas

Araujo-Castro, Marta; Pián, Héctor; Ruz-Caracuel, Ignacio; Cancela, Alberto Acitores; Pascual‐Corrales, Eider; Berrocal, Víctor Rodríguez

doi:10.1530/ec-20-0414

Cited by 9 publications

(5 citation statements)

References 37 publications

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“…Most of them failed to confirm that pretreatment greatly benefits patients (e.g., a better chance to achieve remission following surgery 11 , 12 . Others found pharmacotherapy with somatostatin agonists (SSA) beneficial 13 . This could be given by selecting the patients with invasive adenomas or giant adenoma 14 , 15 .…”

Section: Discussionmentioning

confidence: 99%

Endocrinological aspects of pituitary adenoma surgery in Europe

Netuka

Grotenhuis

Foroglou

et al. 2022

Sci Rep

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Hormone-secreting adenomas are treated in many neurosurgical centers within Europe. The goal of the survey is to understand variance in practice management of pituitary tumors amongst neurosurgical centers. A list of departments performing pituitary surgery was created. The survey consisted of 58 questions. This study focuses on neurosurgical care of hormone-secreting adenomas. For analysis, the departments were divided into four subgroups: academic/non-academic, high-volume/low-volume, “mainly endoscopic/mainly microscopic practice” and geographical regions. Data from 254 departments from 34 countries were obtained. Most centers surgically treat 1–5 hormone-secreting adenomas per year. In prolactinomas this is the case in 194 centers, (76.4%), in GH-secreting adenomas: 133 centers, (52.4%), ACTH-secreting adenomas: 172 centers, (69.8%). Surgery as a primary treatment of prolactinomas is considered in 64 centers (25.2%). In 47 centers (18.8%), GH-secreting microadenomas are often treated pharmacologically first. Debulking surgery for an invasive GH-secreting adenoma in which hormonal remission is not a realistic goal of the surgery and the patient has no visual deficit surgery is always or mostly indicated in 156 centers (62.9%). Routine postoperative hydrocortisone replacement therapy is administered in 147 centers (58.6%). Our survey shows that in most centers, few hormone-secreting adenomas are treated per year. In about 25% of the centers, prolactinoma surgery may be regarded as first-line treatment; in about 20% of the centers, medical treatment is the first-line treatment for GH-secreting adenomas. Pretreatment for ACTH-secreting adenomas is routinely used in 21% of centers. This survey may serve as plea for neurosurgical care centralization of hormone-secreting adenomas.

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Section: Discussionmentioning

confidence: 99%

Endocrinological aspects of pituitary adenoma surgery in Europe

Netuka

Grotenhuis

Foroglou

et al. 2022

Sci Rep

View full text Add to dashboard Cite

show abstract

“…Most of them failed to con rm that pretreatment greatly bene ts patients (e.g., a better chance to achieve remission following surgery [10,11]. Others found pharmacotherapy with somatostatin agonists (SSA) bene cial [12]. This could be given by selecting the patients with invasive adenomas or giant adenoma [13,14].…”

Section: Discussionmentioning

confidence: 99%

Endocrinological Aspects of Pituitary Adenoma Surgery in Europe

Netuka

Grotenhuis

Foroglou

et al. 2021

Preprint

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Purpose:Hormone-secreting adenomas are treated in many neurosurgical centers within Europe. The goal of the survey is to shed light on different endocrinological aspects of hormone-secreting adenomas surgery.Methods: A list of departments performing pituitary surgery was created. The survey consisted of 58 questions. This study focuses on neurosurgical care of hormone-secreting adenomas. For analysis, the departments were divided into four subgroups: academic/non-academic, high-volume/low-volume, “mainly endoscopic/mainly microscopic practice” and geographical regions. Results: Data from 254 departments from 34 countries were obtained. Most centers surgically treat 1-5 hormone-secreting adenomas per year. In prolactinomas this is the case in 194 centers, (76.4%), in GH-secreting adenomas: 133 centers, (52.4%), ACTH-secreting adenomas: 172 centers, (69.8%). Surgery as a primary treatment of prolactinomas is considered in 64 centers (25.2%). In 47 centers (18.8%), GH-secreting microadenomas are often treated pharmacologically first. Debulking surgery for an invasive GH-secreting adenoma in which hormonal remission is not a realistic goal of the surgery and the patient has no visual deficit surgery is always or mostly indicated in 156 centers (62.9%). Routine postoperative hydrocortisone replacement therapy is administered in 147 centers (58.6%). Conclusions:Our survey shows that in most centers, few hormone-secreting adenomas are treated per year. In about 25% of the centers, prolactinoma surgery may be regarded as first-line treatment; in about 20% of the centers, medical treatment is the first-line treatment for GH-secreting adenomas. Pretreatment for ACTH-secreting adenomas is routinely used in 21% of centers. This survey may serve as plea for neurosurgical care centralization of hormone-secreting adenomas.

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“…A conventional endoscopic endonasal approach was used in all surgeries. Tumour consistency was classified in hard tumours when they were difficult to remove with ring curettes and required sharp dissection, bipolar cautery and/or surgical aspirator and the rest were classified as soft tumours [23].…”

Section: Surgical Procedures and Histological Analysismentioning

confidence: 99%

The Dose of Somatostatin Analogues during Pre-Surgical Treatment Is a Key Factor to Achieve Surgical Remission in Acromegaly

et al. 2021

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Purpose: to determine whether pre-surgical treatment using long-acting somatostatin analogues (SSAs) may improve surgical outcomes in acromegaly. Methods: retrospective study of 48 patients with acromegaly operated by endoscopic transsphenoidal approach and for first time. Surgical remission was evaluated based on the 2010 criteria. Results: most patients, 83.3% (n = 40), harbored macroadenomas and 31.3% (n = 15) invasive pituitary adenomas. In this case, 14 patients were treated with lanreotide LAR and 6 with octreotide LAR, median monthly doses of 97.5 [range 60–120] and 20 [range 20–30] mg, respectively, for at least 3 months preoperatively. Presurgical variables were comparable between pre-treated and untreated patients (p > 0.05). Surgical remission was more frequent in those pre-treated with monthly doses ≥90 mg of lanreotide or ≥30 mg of octreotide than in untreated or pre-treated with lower doses (OR = 4.64, p = 0.025). However, no differences were found between pre-treated and untreated patients when lower doses were included or between those treated for longer than 6 months compared to those untreated or pre-treated for shorter than 6 months. Similarly, no differences were found either in terms of surgical or endocrine complications (OR = 0.65, p = 0.570), independently of the doses and the duration of SSA treatment (p > 0.05). Conclusions: the dose of SSAs is a key factor during pre-surgical treatment, since the beneficial effects in surgical remission were observed with monthly doses equal or higher than 90 mg of lanreotide and 30 mg of octreotide, but not with lower doses.

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Presurgical somatostatin receptor ligand treatment does not affect tumor consistency in GH-secreting pituitary macroadenomas

Cited by 9 publications

References 37 publications

Endocrinological aspects of pituitary adenoma surgery in Europe

Endocrinological aspects of pituitary adenoma surgery in Europe

Endocrinological Aspects of Pituitary Adenoma Surgery in Europe

The Dose of Somatostatin Analogues during Pre-Surgical Treatment Is a Key Factor to Achieve Surgical Remission in Acromegaly

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