Growth Hormone and IGF Research ( IF 1.4 ) Pub Date : 2020-08-27 , DOI: 10.1016/j.ghir.2020.101342 Halit Diri 1 , Ersin Ozaslan 2 , Ali Kurtsoy 3 , Fahri Bayram 1
Aim
The aim of this study was to clarify the prognostic values of various preoperative factors, including the surgeon's ability as well as the patient's age, gender, tumor size, cavernous sinus invasion, compression of the optic chiasm, hypopituitarism, immunohistochemical (IHC) staining pattern of the adenoma, and insulin-like growth factor-1 (IGF-1) level, in acromegalic patients who had undergone pituitary surgery.
Study design
This single-center, retrospective study assessed the medical records of 108 patients who had undergone pituitary surgery with the same neurosurgical team.
Results
The mean total follow-up period after surgery was 44.8 (min: 24, max: 59) months. Remission was reported in 67 (62.0%) patients, and 57 (52.8%) patients did not experience recurrence. Initial tumor volume, IGF-1 level, and optic chiasm compression, but not patients' age, gender, cavernous sinus invasion, and IHC staining patterns of the adenoma, were prognostic of either remission or recurrence. An IGF-1 level of 860 ng/mLwas found to be a convenient cut-off point for determining remission.
Conclusions
The experience of the surgical team suggests that the initial tumor volume, IGF-1 level, and optic chiasm compression have high prognostic values in relation to pituitary surgery for patients with acromegaly.
中文翻译:
一项评估与肢端肥大症预后相关的预测因素的单中心观察性研究。
目的
本研究的目的是阐明各种术前因素的预后价值,包括外科医生的能力以及患者的年龄、性别、肿瘤大小、海绵窦浸润、视交叉受压、垂体功能减退、免疫组织化学 (IHC) 染色模式接受垂体手术的肢端肥大症患者的腺瘤和胰岛素样生长因子-1 (IGF-1) 水平。
学习规划
这项单中心、回顾性研究评估了 108 名在同一神经外科团队接受过垂体手术的患者的医疗记录。
结果
手术后的平均总随访时间为 44.8(最少:24,最多:59)个月。67 名 (62.0%) 患者报告缓解,57 名 (52.8%) 患者未复发。初始肿瘤体积、IGF-1 水平和视交叉受压,但不是患者的年龄、性别、海绵窦浸润和腺瘤的 IHC 染色模式,是缓解或复发的预后。发现 860 ng/mL 的 IGF-1 水平是确定缓解的一个方便的分界点。
结论
手术团队的经验表明,初始肿瘤体积、IGF-1 水平和视交叉受压对于肢端肥大症患者的垂体手术具有很高的预后价值。