Postoperative use of somatostatin analogs and mortality in patients with acromegaly
| العنوان: | Postoperative use of somatostatin analogs and mortality in patients with acromegaly |
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| المؤلفون: | Wim J. Sluiter, André P van Beek, Margreet A E M Wagenmakers, Ad R. M. M. Hermus, Bruce H. R. Wolffenbuttel, Thalijn L C Wolters, Antonius E. van Herwaarden, Gerrit van den Berg, Romana T. Netea-Maier, Anneke C. Muller Kobold, Mark R Postma, Alfons C.M. van den Bergh |
| المساهمون: | Internal Medicine, Lifestyle Medicine (LM), Center for Liver, Digestive and Metabolic Diseases (CLDM), Guided Treatment in Optimal Selected Cancer Patients (GUTS) |
| المصدر: | European Journal of Endocrinology, 180(1), 1-9. Bioscientifica Ltd European Journal of Endocrinology, 180, 1-9 European Journal of Endocrinology, 180(1), 1-9. BIOSCIENTIFICA LTD European Journal of Endocrinology, 180, 1, pp. 1-9 |
| سنة النشر: | 2019 |
| مصطلحات موضوعية: | Male, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, Vascular damage Radboud Institute for Health Sciences [Radboudumc 16], THERAPY, 0302 clinical medicine, Endocrinology, Quality of life, QUALITY-OF-LIFE, CRITERIA, Postoperative Period, PREDICTORS, Craniotomy, Univariate analysis, General Medicine, Middle Aged, Combined Modality Therapy, Women's cancers Radboud Institute for Health Sciences [Radboudumc 17], IGF-I, GH, Survival Rate, 030220 oncology & carcinogenesis, Pituitary Gland, Female, GROWTH-HORMONE, Somatostatin, RADIOTHERAPY, Adenoma, Adult, medicine.medical_specialty, 030209 endocrinology & metabolism, Rare cancers Radboud Institute for Molecular Life Sciences [Radboudumc 9], 03 medical and health sciences, All institutes and research themes of the Radboud University Medical Center, Internal medicine, Acromegaly, MANAGEMENT, medicine, Humans, Pituitary Neoplasms, Survival rate, Retrospective Studies, business.industry, Retrospective cohort study, medicine.disease, Radiation therapy, Relative risk, CONSENSUS, business |
| الوصف: | Objective To assess the effect of somatostatin analogs (SSAs) on mortality in relation to disease control of acromegaly after pituitary surgery. Design A retrospective study in two large tertiary referral centers in The Netherlands. Methods Overall, 319 patients with acromegaly in whom pituitary surgery was performed as primary therapy between January 1980 and July 2017 were included. Postoperative treatment with SSA was prescribed to 174 (55%) patients because of persistent or recurrent disease. Disease control at last visit was assessed by IGF1 standard deviation score (SDS). Adequate disease control was defined as IGF1 SDS ≤2. Univariate determinants of mortality and standardized mortality ratios (SMRs) were calculated for groups with and without SSA at any moment postoperatively and at last visit. Results In total, 27 deaths were observed. In univariate analysis, determinants of mortality were inadequate disease control (relative risk (RR): 3.41, P = 0.005), surgery by craniotomy (RR: 3.53, P = 0.013) and glucocorticoid substitution (RR: 2.11, P = 0.047). There was a strong trend toward increased mortality for patients who used SSA (RR: 2.01, P = 0.067) and/or dopamine agonists (RR: 2.54, P = 0.052) at last visit. The SMR of patients with adequate disease control who used SSA at any moment postoperatively (1.07, P = 0.785) and at last visit (1.19; P = 0.600) was not increased. Insufficiently controlled patients had a significantly raised SMR (3.92, P = 0.006). Conclusions Postoperative use of SSA is not associated with increased mortality in patients with acromegaly who attain adequate disease control. In contrast, inadequate disease control, primary surgery by craniotomy and glucocorticoid substitution are associated with increased mortality. |
| وصف الملف: | application/pdf |
| تدمد: | 0804-4643 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::d59dd8329bc0a055cf4e379b17bb0329Test https://doi.org/10.1530/eje-18-0166Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....d59dd8329bc0a055cf4e379b17bb0329 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 08044643 |
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