Çağlar Keskin1, Özgür Demir2, Alper Çağrı Karcı3, Dilek Berker3, Zeynep Cantürk4, Güzin Fidan Yaylali5, Şenay Topsakal5, Reyhan Ersoy6, Fahri Bayram7, Melek Eda Ertörer8, Emre Bozkırlı8, Filiz Haydardedeoğlu8, Esra Nur Ademoğlu Dilekçi9, Seyid Ahmet Ay10, Güven Barış Cansu11, Mustafa Şahin2, Rıfat Emral2, Demet Çorapçıoğlu2. 1. Ankara University, Faculty of Medicine, Department of Endocrinology and Metabolic Diseases, Ankara, Turkey. Electronic address: caglaron@hotmail.com. 2. Ankara University, Faculty of Medicine, Department of Endocrinology and Metabolic Diseases, Ankara, Turkey. 3. Ankara Numune Training and Research Hospital, Department of Endocrinology and Metabolic Diseases, Ankara, Turkey. 4. Kocaeli University, Faculty of Medicine, Department of Endocrinology and Metabolic Diseases, Kocaeli, Turkey. 5. Pamukkale University, Faculty of Medicine, Department of Endocrinology and Metabolic Diseases, Denizli, Turkey. 6. Yıldırım Beyazıt University, Faculty of Medicine, Department of Endocrinology and Metabolic Diseases, Ankara, Turkey. 7. Erciyes University, Faculty of Medicine, Department of Endocrinology and Metabolic Diseases, Kayseri, Turkey. 8. Başkent University, Adana Dr. Turgut Noyan Training and Research Hospital, Department of Endocrinology and Metabolic Diseases, Adana, Turkey. 9. Abant İzzet Baysal University, Faculty of Medicine, Department of Endocrinology and Metabolic Diseases, Bolu, Turkey. 10. GATA Haydarpaşa Training Hospital, Department of Endocrinology and Metabolic Diseases, İstanbul, Turkey. 11. Eskişehir Yunus Emre Hospital, Department of Endocrinology and Metabolic Diseases, Eskişehir, Turkey.
Abstract
OBJECTIVES: To describe biochemical and clinical features, and therapeutic outcomes of acromegaly patients in Turkey. METHODS: Retrospective multicenter epidemiological study of 547 patients followed in 10 centers of the Turkish Acromegaly registry. RESULTS: A total of 547 acromegaly patients (55% female) with a median age of 41 was included in this study. Majority of patients had a macroadenoma (78%). Transsphenoidal surgery was performed as primary treatment in 92% of the patients (n = 503). Surgical remission rate was 39% (197/503) in all operated patients. Overall disease control was achieved in 70% of patients. Remission group were significantly older than non-remission group (p = .002). Patients with microadenomas had significantly higher remission rates than patients with macroadenomas (p < .001). Patients with microadenomas were significantly older at the time of diagnosis when compared to patients with macroadenomas (p < .001). Preoperative growth hormone (GH) and insulin-like growth factor 1 (IGF-1) levels were significantly lower in the remission group (p < .001). Initial IGF-1 and GH levels were significantly higher in macroadenomas compared to microadenomas (p < .001). Medical treatment was administered as a second-line treatment (97%) in almost all patients without remission. Radiotherapy was preferred in 21% of the patients mostly as a third line treatment. CONCLUSIONS: This is one of the largest real life studies evaluating the epidemiological characteristics and treatment outcomes of patients with acromegaly who were followed in different centers in Turkey. Transsphenoidal surgery in the treatment of acromegaly still remains the most valid method. Medical treatment options may improve long-term disease outcomes in patients who cannot be controlled with surgical treatment (up to 70%).
OBJECTIVES: To describe biochemical and clinical features, and therapeutic outcomes of acromegalypatients in Turkey. METHODS: Retrospective multicenter epidemiological study of 547 patients followed in 10 centers of the Turkish Acromegaly registry. RESULTS: A total of 547 acromegalypatients (55% female) with a median age of 41 was included in this study. Majority of patients had a macroadenoma (78%). Transsphenoidal surgery was performed as primary treatment in 92% of the patients (n = 503). Surgical remission rate was 39% (197/503) in all operated patients. Overall disease control was achieved in 70% of patients. Remission group were significantly older than non-remission group (p = .002). Patients with microadenomas had significantly higher remission rates than patients with macroadenomas (p < .001). Patients with microadenomas were significantly older at the time of diagnosis when compared to patients with macroadenomas (p < .001). Preoperative growth hormone (GH) and insulin-like growth factor 1 (IGF-1) levels were significantly lower in the remission group (p < .001). Initial IGF-1 and GH levels were significantly higher in macroadenomas compared to microadenomas (p < .001). Medical treatment was administered as a second-line treatment (97%) in almost all patients without remission. Radiotherapy was preferred in 21% of the patients mostly as a third line treatment. CONCLUSIONS: This is one of the largest real life studies evaluating the epidemiological characteristics and treatment outcomes of patients with acromegaly who were followed in different centers in Turkey. Transsphenoidal surgery in the treatment of acromegaly still remains the most valid method. Medical treatment options may improve long-term disease outcomes in patients who cannot be controlled with surgical treatment (up to 70%).