Acromegaly and Colorectal Neoplasm: An Update

Kasuki, Leandro; Maia, Bernardo Porto; Gadelha, Mônica R.

doi:10.3389/fendo.2022.924952

Cited by 16 publications

(7 citation statements)

References 87 publications

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“…The risk of colorectal cancer was moderately elevated in our cohort, consistent with many studies [ 38 ]. Most were diagnosed after acromegaly, even when the follow-up time was relatively short.…”

Section: Discussionsupporting

confidence: 92%

Incidence and risk factors of cancers in acromegaly: a Chinese single-center retrospective study

et al. 2023

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Purpose To evaluate the incidence of malignancies in acromegaly and to identify risk factors for newly-diagnostic cancers, especially the excessive growth hormone (GH) and insulin-like growth factor-1 (IGF-1). Methods A retrospective cohort including 1738 consecutive hospitalized patients with acromegaly in a single referral center between 2012 and 2020 (mean follow-up 4.3 years). A gender- and age-matched case-control study (280 patients from the cohort) was performed for risk factor analysis. Results One hundred thirteen malignancies (67 diagnosed after acromegaly) were observed. The overall newly-diagnostic cancer risk of acromegaly was higher than the general population (standardized incidence ratio (SIR) 2.81; 95% CI 2.18–3.57). The risk of thyroid cancer (n = 33, SIR 21.42; 95% CI 13.74–30.08) and colorectal cancer (n = 8, SIR 3.17; 95% CI 1.37–6.25) was elevated. In the overall cohort, IGF-1 (ULN: 1.27 vs. 0.94, p = 0.057), GH (1.30 vs. 1.00 ng/ml, p = 0.12), and disease-controlled rate (34.9% vs. 45.9%, p = 0.203) at the last visit did not reach significance between patients with and without post-diagnostic cancer. In the case-control study, GH (1.80 vs. 0.90 ng/ml, p = 0.018) and IGF-1 (ULN: 1.27 vs. 0.91, p = 0.003) at the last visit were higher in patients with post-diagnostic cancers, with a lower disease-controlled rate. Elder age was a risk factor for cancer. Other metabolic comorbidities and the size of pituitary tumors were similar. Conclusion The risk of malignancies, especially thyroid cancer, was increased in patients with acromegaly in our center. More cancer screening should be considered when managing acromegaly, especially in patients with higher posttreatment GH and IGF-1.

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Section: Discussionsupporting

confidence: 92%

Incidence and risk factors of cancers in acromegaly: a Chinese single-center retrospective study

et al. 2023

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“…The metabolic complications, including insulin resistance and diabetes mellitus, increase the risk of cardiovascular-related morbidity and mortality [ 1 , 6 ]. Further, increased levels of IGF-1 has been associated with increased risk for several malignancies [ 7 ], and studies have suggested GH and IGF-1 to facilitate a tumor microenvironment and neoplastic growth in the colon [ 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

Trends in incidence and mortality risk for acromegaly in Norway: a cohort study

et al. 2022

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Purpose Recent data have shown a decreasing overall mortality in acromegaly over the last decades. However, cancer incidence and cancer-related mortality still appear to be increased. Our aim was to obtain updated epidemiological data from Norway in a clinically well-defined cohort with complete register-based follow-up. Methods Patients diagnosed with acromegaly from South-Eastern Norway between 1999–2019 (n = 262) and age and sex matched population controls (1:100) were included (n = 26,200). Mortality and cancer data were obtained from the Norwegian Cause of Death and Cancer Registry. Mortality and cancer incidence were compared by Kaplan–Meier analyses and Cox regression; we report hazard ratios (HRs) with 95% confidence intervals (95% CI). Results Median age at diagnosis was 48.0 years (interquartile range (IQR): 37.6–58.0). Mean annual acromegaly incidence rate was 4.7 (95% CI 4.2–5.3) cases/106 person-years, and the point prevalence (2019) was 83 (95% CI 72.6–93.5) cases/106 persons. Overall mortality was not increased in acromegaly, HR 0.8 (95% CI 0.5–1.4), cancer-specific and cardiovascular-specific mortality was also not increased (HR: 0.7 (95% CI 0.3–1.8) and 0.8 (95% CI: 0.3–2.5) respectively). The HR for all cancers was 1.45 (1.0–2.1; p = 0.052). Conclusion In this large cohort study, covering the period 1999–2019, patients were treated with individualized multimodal management. Mortality was not increased compared to the general population and comparable with recent registry studies from the Nordic countries and Europe. Overall cancer risk was slightly, but not significantly increased in the patients.

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“…MiR-215-5p is downregulated in colorectal cancer tissues, possibly acting as a tumor suppressor [ 96 ]. As patients with acromegaly have an increased colorectal cancer risk [ 4 , 97 ], miR-215-5p could be a target for further research in this context.…”

Section: Circulating Mirnas In Acromegalymentioning

confidence: 99%

MicroRNA in Acromegaly: Involvement in the Pathogenesis and in the Response to First-Generation Somatostatin Receptor Ligands

Henriques

Lamback

Dezonne

et al. 2022

IJMS

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Acromegaly is a chronic and systemic disease due to excessive growth hormone and insulin-like growth factor type I caused, in the vast majority of cases, by a GH-secreting pituitary adenoma. About 40% of these tumors have somatic mutations in the stimulatory G protein alpha-subunit 1 gene. The pathogenesis of the remaining tumors, however, is still not fully comprehended. Surgery is the first-line therapy for these tumors, and first-generation somatostatin receptor ligands (fg-SRL) are the most prescribed medications in patients who are not cured by surgery. MicroRNAs are small, non-coding RNAs that control the translation of many mRNAs, and are involved in the post-transcriptional regulation of gene expression. Differentially expressed miRNAs can explain differences in the pathogenesis of acromegaly and tumor resistance. In this review, we focus on the most validated miRNAs, which are mainly involved in acromegaly’s tumorigenesis and fg-SRL resistance, as well as in circulating miRNAs in acromegaly.

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Acromegaly and Colorectal Neoplasm: An Update

Cited by 16 publications

References 87 publications

Incidence and risk factors of cancers in acromegaly: a Chinese single-center retrospective study

Incidence and risk factors of cancers in acromegaly: a Chinese single-center retrospective study

Trends in incidence and mortality risk for acromegaly in Norway: a cohort study

MicroRNA in Acromegaly: Involvement in the Pathogenesis and in the Response to First-Generation Somatostatin Receptor Ligands

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