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Erschienen in:

04.01.2021 | Clinical Study

Predictors of postoperative biochemical remission in acromegaly

verfasst von: Shun Yao, Wen-Li Chen, Sherwin Tavakol, Farhana Akter, Michael P. Catalino, Xiaopeng Guo, Jie Luo, Ai-Liang Zeng, Leo Zekelman, Zhi-Gang Mao, Yong-Hong Zhu, Qing-Zhi Wu, Edward R. Laws Jr, Wenya Linda Bi, Hai-Jun Wang

Erschienen in: Journal of Neuro-Oncology | Ausgabe 2/2021

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Abstract

Purpose

Acromegaly is a rare neuroendocrine condition that can lead to significant morbidity. Despite China’s vast population size, studies on acromegaly remain sparse. This study aimed to investigate the clinical characteristics and predictors of biochemical remission after surgery for acromegaly using the China Acromegaly Patient Association (CAPA) database.

Methods

A retrospective nationwide study was conducted using patient-reported data from CAPA database between 1998 and 2018. The principal component analysis (PCA) and logistic regression analysis were employed to determine independent predictors of biochemical remission at 3 months in patients after surgery.

Results

Of the 546 surgical cases (mean age: 36.8 years; 59.5% females), macroadenomas and invasive tumors (Knosp score 3–4) were 83.9% and 64.1%, respectively. Ninety-five percent of patients were treated with endonasal surgery and 36.8% exhibited biochemical remission at 3-months postoperatively. The following independent predictors of biochemical remission were identified: preoperative growth hormone (GH) levels between 12 and 28 μg/L [odds ratio (OR) = 0.58; 95% confidence interval (CI), 0.37–0.92; p = 0.021], preoperative GH levels > 28 μg/L (OR = 0.55; 95% CI, 0.34–0.88; p = 0.013), macroadenoma (OR = 0.56; 95% CI, 0.32–0.96; p = 0.034), giant adenomas (OR = 0.14; 95% CI, 0.05–0.38; p < 0.001), Knosp score 3–4 (OR = 0.37; 95% CI, 0.24–0.57; p < 0.001), and preoperative medication usage (OR = 2.32; 95% CI, 1.46–3.70; p < 0.001).

Conclusions

In this nationwide study spanning over two decades, we highlight that higher preoperative GH levels, large tumor size, and greater extent of tumor invasiveness are associated with a lower likelihood of biochemical remission at 3-months after surgery, while preoperative medical therapy increases the chance of remission.

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Titel: Predictors of postoperative biochemical remission in acromegaly
verfasst von: Shun Yao
Wen-Li Chen
Sherwin Tavakol
Farhana Akter
Michael P. Catalino
Xiaopeng Guo
Jie Luo
Ai-Liang Zeng
Leo Zekelman
Zhi-Gang Mao
Yong-Hong Zhu
Qing-Zhi Wu
Edward R. Laws Jr
Wenya Linda Bi
Hai-Jun Wang
Publikationsdatum: 04.01.2021
Verlag: Springer US
Erschienen in: Journal of Neuro-Oncology / Ausgabe 2/2021
Print ISSN: 0167-594X
Elektronische ISSN: 1573-7373
DOI: https://doi.org/10.1007/s11060-020-03669-4

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