This Article Full Text Full Text (PDF) Submit a related Letter to the Editor Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Copyright Permission Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Biermasz, N. R. Articles by Roelfsema, F. Search for Related Content PubMed PubMed Citation Articles by Biermasz, N. R. Articles by Roelfsema, F.

Direct Postoperative and Follow-Up Results of Transsphenoidal Surgery in 19 Acromegalic Patients Pretreated with Octreotide Compared to Those in Untreated Matched Controls

Department of Endocrinology, Leiden University Medical Center, 2333AA Leiden, The Netherlands

Address all correspondence and requests for reprints to: Dr. F. Roelfsema, Department of Endocrinology, Leiden University Medical Center, Albinusdreef 2, 2333 AA Leiden, The Netherlands.

In this study 19 patients were preoperatively treated with octreotide for 1–17 months (mean, 5 months), with doses from 150–1500 µg daily, and those patients were matched to 19 untreated patients with comparable tumor classification and preoperative serum GH concentrations. Octreotide was started at 300 µg daily by sc injections or continuous sc infusion using a pump in increasing doses, depending on the responses of the serum GH and insulin-like growth factor I (IGF-I) concentrations. During pretreatment, seven patients achieved a serum GH concentration below 5 mU/L, whereas six patients normalized their serum IGF-I.

Postoperatively, a serum GH concentration below 5 mU/L was achieved in 15 pretreated and 14 untreated patients, a normal serum IGF-I level (<2 SD) was achieved in 10 pretreated and 15 untreated patients, and normal serum GH suppression during GTT was reached in 12 treated and 14 control patients. No differences were found in complication rate or incidence of hypopituitarism caused by surgery.

Adjuvant therapy was required in 7 treated and 5 untreated patients. At follow-up examination, 5.7 and 4 yr postoperatively, 10 pretreated and 12 control patients could be considered cured by surgery only, according to our criteria for remission (serum GH, <5 mU/L; normal GH suppression and normal serum IGF-I). In summary, we found no difference in direct postoperative and follow-up results of transsphenoidal surgery between pretreated patients and untreated patients. This finding is in discordance with other studies, which have claimed a beneficial effect of octreotide pretreatment.

This article has been cited by other articles:

				A. Beckers Does Preoperative Somatostatin Analog Treatment Improve Surgical Cure Rates in Acromegaly? A New Look at an Old Question J. Clin. Endocrinol. Metab., August 1, 2008; 93(8): 2975 - 2977. [Full Text] [PDF]

				S. M. Carlsen, M. Lund-Johansen, T. Schreiner, S. Aanderud, O. Johannesen, J. Svartberg, J. G. Cooper, J. K. Hald, S. L. Fougner, J. Bollerslev, et al. Preoperative Octreotide Treatment in Newly Diagnosed Acromegalic Patients with Macroadenomas Increases Cure Short-Term Postoperative Rates: A Prospective, Randomized Trial J. Clin. Endocrinol. Metab., August 1, 2008; 93(8): 2984 - 2990. [Abstract] [Full Text] [PDF]

				P. U. Freda, L. Katznelson, A. J. van der Lely, C. M. Reyes, S. Zhao, and D. Rabinowitz Long-Acting Somatostatin Analog Therapy of Acromegaly: A Meta-Analysis J. Clin. Endocrinol. Metab., August 1, 2005; 90(8): 4465 - 4473. [Abstract] [Full Text] [PDF]

				Z Merza Modern treatment of acromegaly Postgrad. Med. J., April 1, 2003; 79(930): 189 - 194. [Abstract] [Full Text] [PDF]

				J. J. Kopchick, C. Parkinson, E. C. Stevens, and P. J. Trainer Growth Hormone Receptor Antagonists: Discovery, Development, and Use in Patients with Acromegaly Endocr. Rev., October 1, 2002; 23(5): 623 - 646. [Abstract] [Full Text] [PDF]

				P. U. Freda Somatostatin Analogs in Acromegaly J. Clin. Endocrinol. Metab., July 1, 2002; 87(7): 3013 - 3018. [Full Text] [PDF]

				N. R. Biermasz, H. van Dulken, and F. Roelfsema Ten-Year Follow-Up Results of Transsphenoidal Microsurgery in Acromegaly J. Clin. Endocrinol. Metab., December 1, 2000; 85(12): 4596 - 4602. [Abstract] [Full Text]