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• W2024293019 abstract "Transsphenoidal surgery is currently the first-line treatment of acromegaly. Remission is observed in 80 to 90% microadenomas, 50 to 60% non-invasive macroadenomas, and less than 20% invasive macroadenomas. Predictive factors include age, maximal size of the adenoma, cavernous sinus invasion, initial hormone levels and neurosurgeon's experience. Complications are rare, with about 5% definitive diabetes insipidus and 10% of new anterior pituitary hormone deficits. Somatostatin agonist pretreatment can be proposed as it decreases tumor volume in about 25% cases and might reduce the rate of immediate postsurgical complications; however, there is no obvious difference in surgical remission rate whether patients are pretreated or not. Debulking surgery can also be proposed in very large macroadenomas incompletely controlled by somatostatin agonists or resistant to medical treatment, as it was shown to facilitate somatostatin agonist efficacy in more than 50% cases." @default.
• W2024293019 created "2016-06-24" @default.
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• W2024293019 date "2009-04-01" @default.
• W2024293019 modified "2023-10-17" @default.
• W2024293019 title "Does first-line surgery still have its place in the treatment of acromegaly?" @default.
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• W2024293019 doi "https://doi.org/10.1016/j.ando.2009.03.002" @default.
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