Abstract

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The German Acromegaly Register – Surgical outcome in 400 patients


Background: Treatment results for acromegaly remain unsatisfactory. Publications from experienced centres may not represent the overall situation.
Objective: The German Acromegaly Register (expected number of pts=5000 until 2013) documents diagnostic/therapeutic effectiveness, comorbidity/ mortality, compares experienced with not-experienced centres, extracts suggestions for improvement.
Methods: Two trained nurses visit all centres. Software of the UK Acromegaly Database is used.
Results: 502 patients from 18 centres entered as of Dec. 2003. Surgical results from 400 operated pts are reported (incomplete data from early time periods n=119). Basal, 1 and 3 yrs post-surgery GH/IGF-I data are given (Table). 3-yr data include secondary/tertiary treatment with repeat surgery (n=71), medical treatment (n=181), irradiation (n=68). Operative results improved during consecutive time periods, but cure rate did not surpass 54%. Secondary treatment offered little further improvement. Presurgical medical treatment (n=117) reduced GH less than surgery (39.6 -> 13.7 µ/L).
Time period of surgery <Dec. 1983 1984–1992 1993-present
GH (median, n) Pre-OP 30.4 (10) 23.0 (45) 13.7 (226)
1 yr 13.0 (10) 3.7 (33) 2.4 (189)
3 yrs 8.0 (8) 2.4 (26) 2.2 (51)
GH/oGTT <1.0µg/L
(%, n/n)
1 yr 43% (3/7) 50% (10/20) 54% (49/91)
3 yrs 40% (2/5) 67% (10/15) 63% (19/30)
IGF-I normal
and oGTT GH <1.0 µ/L
1 yr no data 20% (4/20) 38% (35/91)
3 yrs no data 40% (6/15) 60% (18/30)
Random GH <2.5µg/L
(%, n/n)
1 yr 0% (0/0) 25% (5/20) 63% (53/94)
3 yrs 0% (0/3) 44% (7/16) 67% (39/58)
Conclusions: Analysis of epidemiological data will be useful for improved diagnostic and therapeutic strategies.
Presenting Author: Prof. Dr. Hans-Jürgen Quabbe / Free University Berlin / 12209 Berlin / Auguststr. 18 / Germany / 0049307721709