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Journal of Korean Neurosurgical Society 1998;27(9): 1244-1249.
Analysis of Factors Affecting Surgical Outcome in Acromegaly.
Jong Hyun Kim, Soo Hyun Hwang, Do Hyun Nam, Jung Il Lee, Jong Soo Kim, Seung Chyul Hong, Hyung Jin Shin, Kwan Park, Whan Eoh
Department of Neurosurgery, Samsung Medical Center, College of Medicine, Sung Kyun Kwan University, Seoul, Korea.
To elucidate the factors associated with surgical outcome, the authors analyzed a consecutive series of 30 acromegalic patients treated between October, 1995 and May, 1997. The mean follow-up period for hormonal evaluation was 14.1(range: 2-30) months. We evaluated the surgical outcome according to the established prognostic factors such as basal growth hormone(GH) level, preoperative insuline-like growth factor-I(lGF-I) level, tumor size, extrasellar extension(grade), suprasellar growth(stage), and immunohistological findings. The criteria of achieving a postoperative basal GH below 5ng/ml, glucose-suppressed growth hormone level of 2ng/ml or less, and/or normalizat1on of IGF-1 level were used to indicate remission. The mean preoperative basal growth hormone level was 39.55(range 2.1-70ng/ml). The mean long diameter of tumors was 16.5mm(range 6-31.1mm). Utilizing the postoperative growth hormone determination, 15(50%) of 30 patients were in remission. Tumor size, extrasellar extension and suprasellar growth were correlated with remission. But preoperative growth hormone level, lGF-1 level, and immunohistochemical findings were not correlated with remission. Even though surgical excision is the most effective therapy currently available for acromegaly, the tumor size and growth pattern may influence on the surgical outcome.
Key Words: Acromegaly; Growth hormone; Pituitary adenoma
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