Ten-Year Follow-Up Results of Transsphenoidal Microsurgery in Acromegaly

Fifty-nine acromegalic patients, transsphenoidally operated by a single neurosurgeon (H.v.D.) were followed for at least 10 yr to assess the late outcome of surgery. Mean follow-up was 16 ± 0.4 yr (range, 10–22). Criteria for remission were a serum GH concentration below 2.5 μg/L, a normal glucose-suppressed GH (oral glucose tolerance test), and a normal serum insulin-like growth factor I (IGF-I) concentration. Mean serum GH concentration decreased from 59 ± 8.7 μg/L to 5.6 ± 1.4 μg/L after surgery. Early postoperative remission rates were 61% (GH, <2.5 μg/L), 67% (suppressed GH), and 60% (both GH <2.5 μg/L and suppressed GH). Early postoperative remission was significantly related to preoperative serum GH concentration (P = 0.023), but not to tumor size. Of 36 patients with postoperative remission (GH, <2.5μ g/L), 9 patients received (prophylactic) radiotherapy for persistent paradoxical reaction to TRH or probable invasive tumor growth. All nine patients are in remission at the end of follow-up. Of the ...