Behandling af akromegali på Århus Universitetshospital. En retrospektiv opgörelse fra perioden 1994-2004
Sammanfattning
Introduction: Traditional treatment of acromegaly comprises surgery and somatostatin analogs (SA), which however is effective in no more than 80%. New treatments are available which prompted us to follow up our results of surgery and/or SA. Patients and methods: In a retrospective design we followed all 41 patients with newly diagnosed acromegaly at Aarhus University Hospital from 1994 to 2004. 35 patients underwent surgery of whom 10 also received SA. Six patients only received SA. The criteria for cure was a nadir GH level < 0.5 µ g/l and/or normalisation of serum IGF-I. Results: The overall cure rate after surgery was 56%. A cure rate of 89% was observed if the tumor size was < 10 mm in maximal diameter. In the surgery-only group serum IGF-I continued to decline when comparing the first and last postoperative levels. Treatment with SA was effective in 40% and a sufficient response with SA as monotherapy was observed in 67%. Serum IGF-I levels were lower in female as compared to male patients both before and after treatment. Conclusions: 1) The treatment outcome of acromegaly in this population is comparable to international standards 2) The continuous decline in IGF-I levels as a function of time after surgery, and the gender difference in IGF-I levels must be accounted for when evaluating individual patients 3) an insufficient response to conventional therapy was observed in 25% of the cases, which is a result that justifies development of new treatment modalities.