ArticleEndocrine2018
Predictors of surgical outcome and early criteria of remission in acromegaly.
Article in Endocrine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 48 papers, 3 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
48 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Real-world evidence of effectiveness and safety of pasireotide in the treatment of acromegaly: a systematic review and meta-analysis.Reviews in endocrine & metabolic disorders · 2025Pooled it
- Influence of gender and sexual hormones on outcomes after pituitary surgery: a systematic review and meta-analysis.Acta neurochirurgica · 2023Pooled it
- Ki67 in endocrine neoplasms: to count or not to count, this is the question! A systematic review from the English language literature.Journal of endocrinological investigation · 2020Pooled it
- ACROBAT Edge: Safety and Efficacy of Switching Injected SRLs to Oral Paltusotine in Patients With Acromegaly.The Journal of clinical endocrinology and metabolism · 2023Trial
- Can acromegaly be controlled in all cases?Journal of neuroendocrinology · 2026Review
- Adenoma receptors and histologic characteristics determining management outcomes.The Journal of clinical endocrinology and metabolism · 2026Review
- Predictors of therapeutic failure in GH and prolactin co-secreting pituitary adenomas.Endocrine connections · 2025Article
- Predictors of growth hormone level on postoperative day one in patients with acromegaly.Endocrine · 2025Article
- Acromegaly: diagnostic challenges and individualized treatment.Expert review of endocrinology & metabolism · 2025Review
- Predictors of biochemical remission after transsphenoidal surgery in a large cohort of acromegaly patients.Pituitary · 2024Article
- Endocrine Outcomes and Associated Predictive Factors for Somatotrophin Pituitary Adenoma after Endoscopic Endonasal Transsphenoidal Surgery: 10 Years of Experience in a Single Institute.Journal of neurological surgery. Part B, Skull base · 2024Article
- Predictors of Remission of Acromegaly following Surgical Treatment in Growth Hormone-Secreting Pituitary Adenoma.Journal of neurological surgery. Part B, Skull base · 2024Article
- Diffusion-weighted imaging does not seem to be a predictor of consistency in pituitary adenomas.Pituitary · 2024Article
- Pathologic Characteristics of Somatotroph Pituitary Tumors-An Observational Single-Center Study.Biomedicines · 2023Article
- Long-term Efficacy and Safety of Pasireotide in Patients With Acromegaly: 14 Years of Single-Center Real-World Experience.The Journal of clinical endocrinology and metabolism · 2023Article
- Prognostic Models in Growth-Hormone- and Prolactin-Secreting Pituitary Neuroendocrine Tumors: A Systematic Review.Diagnostics (Basel, Switzerland) · 2023Review
- Endoscopic endonasal approach for acromegaly: surgical outcomes using 2018 consensus criteria for remission.Archives of endocrinology and metabolism · 2023Article
- Refractory somatotroph adenomas.Pituitary · 2023Review
- miR-383-5p, miR-181a-5p, and miR-181b-5p as Predictors of Response to First-Generation Somatostatin Receptor Ligands in Acromegaly.International journal of molecular sciences · 2023Article
- The evolution in pituitary tumour classification: a clinical perspective.Endocrine oncology (Bristol, England) · 2023Review
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Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTranssphenoidal surgery (TSS) is the cornerstone of acromegaly treatment, however there are no robust predictors of surgical outcome and remission can only be defined three months after surgery. PURPOSE: To analyze if biochemical, demographical, radiological, and immunohistochemical characteristics are predictors of surgical remission and investigate if immediate postoperative GH and IGF-I levels can help defining remission earlier.
methodsConsecutive acromegaly patients submitted to TSS between 2013-2016 were evaluated. Remission criteria was defined as normal IGF-I and GH <1 mcg/L three months after surgery. Data of age, sex, GH and IGF-I levels, tumor volume, cavernous sinus invasion, T2-weighted signal, Ki-67, and granulation pattern were correlated with remission status. GH and IGF-I levels at 24, 48 h, and one week postoperative were evaluated as early criteria of remission.
resultsSixty-nine patients were included (84% macroadenomas) and surgical remission was achieved in 45%. No difference between cured and not cured patients concerning age, gender, preoperative GH or IGF-I levels, tumor volume, T2-weighted signal, Ki-67 and tumor granularity was observed. Remission was obtained in 20 of 36 (56%) of the non-invasive tumors, and in 3 of 16 (19%) of the invasive tumors (p = 0.017). A GH <1.57 mcg/L 48 h after surgery was able to predict remission with 93% sensitivity and 86% specificity and an IGF-I < 231% ULNR one week after surgery predicted remission with 86% sensitivity and 93% specificity.
conclusionCavernous sinus invasion is the only preoperative predictor of surgical remission. GH at 48 h and IGF-I one week after surgery can define earlier not cured patients.
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