Outcome Analysis Of Surgery For Remaining Or Recurring Pituitary Adenomas In Acromegaly

ObjectTo build a database of acromegaly patient records, with all clinical data stored to facilitate following retrospective studies. Then select the desired records from the database to find out possible factors related to outcome of TSS from early 2012 to early 2014 for acromegaly patients, as well as the significance of the surgery as a second therapy.MethodsWe have built up a database with the support of a software company. Records of acromegaly patients that have been treated in PUMCH since 2012 were imported to the database, with some of the descriptional reports that may be wanted in studies recognized and recorded manually. We selected the records of those who underwent TSS from early 2012 to early 2014 by the same group of doctors with lots of experiences, keeping those with complete clinical data and at lease some follow-up records. We got 101 records in total, among which 81 (80.2%) have never been treated before and 20 (19.8%) have been treated whether in other hospitals or in PUMCH. We classified the treated-before patients into cured and non-cured groups based on the postoperative outcome, and analyzed variables including gender, age, duration, tumor size, tumor fibrosis, endocrine levels and invasion. Then we classified all the records into invasive and non-invasive groups, and assessed the necessity of surgery as a second treatment for each group.ResultsNo significant relationships were found between surgery outcome and variables including gender, age, preoperative endocrine levels, tumor size, tumor fibrosis and preoperative pharmacotherapy while tumor invasion showed significance in predicting outcome of TSS as a second therapy. No significant differences were observed in curative rates and complication rates between treated-before and non-treated-before groups. Patients with invasive tumors undergoing TSS as second therapy were more likely to occur diabetes insipidus.ConclusionsTSS as a second therapy is effective in lowering the GH levels. The curative rate seems to be decreased, but the surgery matters to help with improvement of mortality, life quality and outcome of postoperative adjuvant therapies. TSS as a second therapy is relatively safe, since only diabetes insipidus increases in patients with invasive tumors. Better outcome is got for patients with non-invasive tumors.