Evidence map›Paper›PMID 38587609›Full record

SynthesisJournal of neuro-oncology2024

Assessment of multimodal treatment options in recurrent and persistent acromegaly: a systematic review and meta-analysis.

Seyed Farzad Maroufi, Manijeh Assar, MirHojjat Khorasanizadeh, Fatemeh Mahdavi Sabet, Mohammadmahdi Sabahi, Rocco Dabecco, Badih Adada, Gabriel Zada, Hamid Borghei-Razavi

Abstract readSystematic ReviewMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Journal of neuro-oncology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Seyed Farzad MaroufiNeurosurgery Research Network (NRN), Universal Scientific Education and Research Network (USERN), Tehran, Iran.
Manijeh AssarDepartment of Surgery, University of Florida, Jacksonville, FL, USA.
MirHojjat KhorasanizadehDepartment of Neurosurgery, Mount Sinai Hospital, Icahn School of Medicine, New York City, NY, USA.
Fatemeh Mahdavi SabetNeurosurgery Research Network (NRN), Universal Scientific Education and Research Network (USERN), Tehran, Iran.
Mohammadmahdi SabahiDepartment of Neurological Surgery, Pauline Braathen Neurological Centre, Cleveland Clinic Florida, Weston, FL, USA.
Rocco DabeccoDepartment of Neurological Surgery, Pauline Braathen Neurological Centre, Cleveland Clinic Florida, Weston, FL, USA.
Badih AdadaDepartment of Neurological Surgery, Pauline Braathen Neurological Centre, Cleveland Clinic Florida, Weston, FL, USA.
Gabriel ZadaDepartment of Neurosurgery, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Hamid Borghei-RazaviDepartment of Neurological Surgery, Pauline Braathen Neurological Centre, Cleveland Clinic Florida, Weston, FL, USA. borgheh2@ccf.org.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeIn patients with acromegaly, secondary treatment options in cases of hormonal non-remission or tumor progression include repeat transsphenoidal surgery (TSS), radiation-based treatment (RT), or medical therapy (MT). In this study, we aim to evaluate the clinical effectiveness of various second-line treatment options for acromegaly.

methodsUsing the PRISMA guideline, a systematic review was performed by searching MEDLINE (PubMed), Web of Science, Scopus, and Cochrane electronic bibliographic databases from conception to the end of 2022. Outcomes of interest included hormonal remission rate, complications, and mortality associated with each treatment modality for refractory acromegaly.

resultsA total of 79 studies including 3,208 refractory acromegaly patients (44.90% males) were analyzed, with a mean patient age of 43.89 years. There was a statistically significant difference between various therapeutic modalities in terms of remission rate, with MT offering the highest remission rate (62.55%), followed by RT (50.15%) and TSS (37.39%). Subgroup analysis of radiotherapeutic and medical modalities did not show a significant difference in remission rate between different kinds of sub-modalities in each treatment approach. Recurrence following secondary treatment was not different in patients treated with reoperation TSS compared to other modalities.

conclusionsThe management of persistent and recurrent acromegaly optimally requires a multimodal approach. In different scenarios of refractory acromegaly based on previous treatment, secondary treatments may vary in terms of remission rate and complications. Medical agents provide considerable effectiveness as a second-line therapy for recurrent or persistent disease. In selected cases, however, reoperation still provides an opportunity for cure or freedom from medications. The findings of this study may help clinicians to prioritize varying options involved in this multifaceted decision-making process.

Indexed as

AcromegalyCombined Modality TherapyHumansNeoplasm Recurrence, LocalAcromegalyMedical therapyMeta-analysisRadiotherapyRecurrenceSystematic reviewTrans-Sphenoidal surgery

Identifiers

PMID38587609

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.