Multi-factor Analysis Of Influencing Factors Of Prognosis Inacromegaly Patients In A Single Center

Objective: This study was aimed at assessing the influencing factors of prognosis in acromegaly patients receiving clinical treatment.Methods:62acromegaly patients visiting the neurosurgical department of the Affiliated First Hospital of Fujian Medical University were collected between January2008and March2014. And there were33cases who met inclusion criteria and did not have any obvious exclusion criteria. We recorded9factors that might affect the outcome in acromegaly patients, including age, sex, pre-treatment course, pre-treatment GH levels, non-neurological complications before treatment, tumor size, tumor invasion, Knosp grading, and therapy method. Statistical analyses were performed with SPSS21.0. Univariate analysis and multivariate analysis were performed using a logistic regression model.Results:33patients were included in the analysis. The cure rates of pituitary microadenomas and macroadenoma were respectively85.71%(6/7) and15.38%(4/26). The cure rate of the cases who had developed non-neurological complications before receiving treatment was54.55%(6/11)，while the cure rate of the cases without any complications was18.18%(4/22).50.00%(7/14) of the noninvasive adenomas and15.79%(3/19) of the invasive pituitary adenomas were cured respectively. The cure rates of Knosp grade0–2and Knosp grade3–4adenomas were respectively46.67%(7/15) and16.67%(3/18). The cure rate of cases whose GH levels were above50μg/L was31.81%(7/22), while whose GH levels below50μg/L was27.27%(3/11). The univariate analysis indicated that non-neurological complications before treatment and tumor size were the influencing factors of prognosis in acromegaly patients. Multivariate analysis showed that pre-treatment non-neurological complications and tumor size were independent risk factors of outcome.Conclusions:1. The tumor size in acromegaly patients and whether the adenoma was invasive were the important factors that affected the clinical outcome of acromegaly.2. When a acromegaly patient with a adenoma classified as Knosp grade0to2, or a preoperative GH level below50μg/L, or had not developed non-neurological complications before receiving treatment, he/she would be more likely to be cured.3. Early detection, early diagnosis, and early treatment for acromegaly, adopting Multimodal therapy, and Emphasizing health education will increase the follow-up rate, which can raise the remission rate of the acromegaly.