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Fluctuation analysis of postoperative secretory status in patients operated for acromegaly

Abstract : Objective The aim of this study was to describe endocrinological outcome in patients operated on for acromegaly. Methods A retrospective study included 167 patients. Patients were assessed in the early postoperative period (EPP), at 3 months (M3), at 1 year (Y1), and then annually. They were classified as grade I (IGF-1 level normal-for-age and positive GH response on oral glucose tolerance test [nadir <0.4 ng/L]); grade II (discordant); or grade III or IV (acromegaly, controlled or uncontrolled under medical therapy, respectively). Results Taking all patients with all grades, 35% changed grades between EPP and M3, 26% between M3 and Y1 and 9% after Y1. In grade I, respectively 22%, 15% and 2% of patients changed grades between EPP and M3, between M3 and Y1, and after Y1, compared to 31%, 6% and 6% in grade IV. Respectively 57%, 67%, and 47% of grade II patients changed grades between EPP and M3, between M3 and Y1, and after Y1; between EPP or M3 and last follow-up (>1 year), respectively 74% and 75% of grade II patients changed grades. Knosp category, resection quality and abnormal GH response (vs. abnormal IGF-1) significantly impacted grade II patients’ outcome. Conclusions Whereas outcome in grades I and III–IV seems to be determined by 1 year, grade II discordant patients’ outcome remains uncertain even after 1 year.
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https://hal-amu.archives-ouvertes.fr/hal-03223199
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Submitted on : Wednesday, May 12, 2021 - 3:34:33 PM
Last modification on : Thursday, May 20, 2021 - 5:38:50 PM
Long-term archiving on: : Friday, August 13, 2021 - 6:40:38 PM

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Thomas Graillon, Frederic Castinetti, Mohamed Boucekine, Thomas Cuny, Isabelle Morange, et al.. Fluctuation analysis of postoperative secretory status in patients operated for acromegaly. Annales d'Endocrinologie, Elsevier Masson, 2020, 81 (1), pp.11-17. ⟨10.1016/j.ando.2019.11.002⟩. ⟨hal-03223199⟩

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