Assessment of long-term remission of acromegaly following surgery

Update item information
Publication Type Journal Article
School or College School of Medicine
Department Neurosurgery
Creator Couldwell, William T.
Other Author Kreiger, Mark. D.; Weiss, Martin H.
Title Assessment of long-term remission of acromegaly following surgery
Date 2003-01-01
Description Object. The criteria for remission of acromegaly following transsphenoidal adenoma resection are in evolution. In the present study the authors evaluate the utility of predicting long-term remission by reference to a single fasting growth hormone (GH) level on the 1st postoperative day. Methods. A retrospective analysis was conducted on 181 patients with acromegaly who underwent transsphenoidal resection between 1973 and 1990 and completed a 5-year follow-up period. Fasting serum GH levels were obtained in all patients on the 1st postoperative day in the absence of exogenous glucocorticoids. All patients participated in a follow-up evaluation lasting at least 5 years, which included measurements of serum insulin-like growth factor-I (IGF-I) levels as an index of acromegalic activity. Among the 181 patients, GH levels ranged from 0 to 8 ng/ml in 131 (72%) on the 1st postoperative day, suggesting biochemical remission. This group included 107 (84%) of the 127 patients with microadenomas, but only 24 (44%) of the 54 with macroadenomas. Nevertheless, 15 (11%) of the 131 patients who initially had attenuated GH levels displayed recurrent acromegaly within the first 2 years (with elevated levels of IGF-I in all cases, and abnormalities appearing on magnetic resonance images in nine cases). Only one of 116 patients in whom the initial postoperative GH level was lower than 2 ng/ml experienced a recurrence, whereas 14 (93%) of the 15 patients with postoperative GH levels between 2.2 and 8 ng/ml subsequently displayed biochemical evidence of acromegaly. Conclusions. The findings indicate that a fasting morning serum GH level lower than 2 ng/ml on the 1st postoperative day portends long-term biochemical remission of acromegaly, whereas higher levels are a significant marker for recurrent disease.
Type Text
Publisher American Association of Neurological Surgeons (AANS)
First Page 719
Last Page 724
Subject Acromegaly; Pituitary adenoma; Transsphenoidal surgery; Growth hormone; Insulin-like growth factor I
Language eng
Bibliographic Citation Kreiger, M. D., Couldwell, W. T., & Weiss, M. H. (2003). Assessment of long-term remission of acromegaly following surgery. Journal of Neurosurgery, 98, 719-24.
Rights Management (c) American Association of Neurological Surgeons
Format Medium application/pdf
Format Extent 51,119 bytes
Identifier ir-main,12600
ARK ark:/87278/s6gb2n38
Setname ir_uspace
Date Created 2012-06-13
Date Modified 2012-06-13
ID 702380
Reference URL https://collections.lib.utah.edu/ark:/87278/s6gb2n38