Clinical characteristics and therapeutic outcomes of acromegalic patients with giant growth hormone-secreting pituitary adenomas: a single-center study of 67 cases
Authors' conclusion
With aggressive multimodal therapy, the biochemical remission rate of acromegalic patients with giant GHPAs is comparable to that of patients with macro adenoma. However, postoperative complications and hypopituitarism need to be closely monitored.
Study context
- Population
- Acromegalic patients with giant or macro GHPAs from the same hospital during the same periodmatched cohort
- Participants
- 67 vs 67
- Exposure
- Giant GHPAs vs macro GHPAs
- Giant GHPAn = 67
- Macro GHPAn = 67reference
- Outcome
- Biochemical remission
- Follow-up
- Median 36 months
Methodological detailssingle-centre, matched for age and gender
- Single-centre
- Matched for age and gender
Main finding
As reported in the abstract
Observational data: associations, not effects.
Further findings
| Outcome | P value |
|---|---|
| Visual impairmentMore frequent with Giant GHPA | P < 0.001 |
| Gonadal axis dysfunctionMore frequent with Giant GHPA | P = 0.008 |
Preoperative GH, IGF-1 and extrasellar invasion
- Higher preoperative fasting GH, nadir GH after OGTT and IGF-1 levels, and higher proportion of extrasellar tumor invasion in the giant adenoma group
Resection and treatment by adenoma size
- As adenoma size increases, total resection rate decreases, and postoperative complications and multimodal treatment strategies increase significantly
Postoperative GH · 1 week postoperatively
- Fasting and nadir GH levels remained higher in the giant group
Other factors (age of onset, age of diagnosis, delayed diagnosis time, metabolic complications, p53 positive rate, Ki-67 index)
- No significant difference between the two groups
Safety
Postoperative complications
- More surgical complications and anterior hypopituitarism in Giant GHPA; complications increase with adenoma size
Original publication
Clinical characteristics and therapeutic outcomes of acromegalic patients with giant growth hormone-secreting pituitary adenomas: a single-center study of 67 cases. Pituitary. Published 17 October 2023. doi:10.
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