Gender differences and temporal trends over two decades in acromegaly: a single center study in 112 patients

Ioachimescu, Adriana G.; Handa, Talin; Goswami, Neevi; Pappy, Adlai; Veledar, Emir; Oyesiku, Nelson M.

doi:10.1007/s12020-019-02123-4

Cited by 16 publications

(22 citation statements)

References 57 publications

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“…Accordingly, rates of total tumor resection were significantly higher in men than in women (92.6% vs 85.5%; p = 0.021), as were rates of remission postsurgery (89.7% vs 76.5%; p < 0.001) [52]. Another single-center retrospective study similarly showed that women had larger tumors despite lower mean IGF-I levels, although there were no differences in histological granulation patterns [53]. Of note, premenopausal women tended to have larger, more aggressive tumor types and lower remission rates than men [52], suggesting a more aggressive natural history and hence more adverse treatment outcomes in this subset of women.…”

Section: What's Newmentioning

confidence: 94%

A Pituitary Society update to acromegaly management guidelines

et al. 2020

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Guidelines and consensus statements ensure that physicians managing acromegaly patients have access to current information on evidence-based treatments to optimize outcomes. Given significant novel recent advances in understanding acromegaly natural history and individualized therapies, the Pituitary Society invited acromegaly experts to critically review the current literature in the context of Endocrine Society guidelines and Acromegaly Consensus Group statements. This update focuses on how recent key advances affect treatment decision-making and outcomes, and also highlights the likely role of recently FDA-approved therapies as well as novel combination therapies within the treatment armamentarium.

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Section: What's Newmentioning

confidence: 94%

A Pituitary Society update to acromegaly management guidelines

et al. 2020

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“…At our PCE, we have an overall rate of biochemical cure at 3 months of 54%. We found a 78% remission rate in microadenomas, and 48% remission rate in macroadenomas ( 83 ). With medical and radiation therapy treatment for persistent/recurrent acromegaly, we found that 65% of patients who were not in remission at 3 month follow-up were able to achieve normal IGF-1 ( 83 ).…”

Section: Operative Treatment Of Acromegalymentioning

confidence: 53%

“…We found a 78% remission rate in microadenomas, and 48% remission rate in macroadenomas ( 83 ). With medical and radiation therapy treatment for persistent/recurrent acromegaly, we found that 65% of patients who were not in remission at 3 month follow-up were able to achieve normal IGF-1 ( 83 ). Other factors that influence the chance of remission and survival include patient age, duration of disease, prior radiotherapy, tumor size, and cavernous sinus invasion/carotid encasement ( 75 ).…”

Section: Operative Treatment Of Acromegalymentioning

confidence: 53%

Surgery for acromegaly: Indications and goals

et al. 2022

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Acromegaly is a disease that occurs secondary to high levels of GH, most often from a hormone-secreting pituitary adenoma, with multisystem adverse effects. Diagnosis includes serum GH and IGF-1 levels, and obtaining an MRI pituitary protocol to assess for a functional pituitary adenoma. Attempted gross total resection of the GH-secreting adenoma is the gold standard in treatment for patients with acromegaly for a goal of biochemical remission. Medical and radiation therapies are available when patients do not achieve biochemical cure after surgical therapy.

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“…Changes in incidence rates by sex and age are less clear ( 257 ). A Swedish regional report based on public health care registries and patient records reported an annual standardized incidence ratio of 18 per million between 2001 and 2011 that did not differ between men and women ( 234 ), while an Icelandic study showed the incidence clearly increased with time to 22 per million in women and 26 per million in men in 2012 ( 223 ).…”

Section: Clinical Spectrummentioning

confidence: 99%

Clinical Biology of the Pituitary Adenoma

et al. 2022

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All endocrine glands are susceptible to neoplastic growth, yet the health consequences of these neoplasms differ between endocrine tissues. Pituitary neoplasms are highly prevalent and overwhelmingly benign, exhibiting a spectrum of diverse behaviors and impact on health. To understand the clinical biology of these common yet often innocuous neoplasms, we review pituitary physiology, and adenoma epidemiology, pathophysiology, behavior, and clinical consequences. The anterior pituitary develops in response to a range of complex brain signals integrating with intrinsic ectodermal cell transcriptional events that together determine gland growth, cell type differentiation, and hormonal production, in turn maintaining optimal endocrine health. Pituitary adenomas occur in ten percent of the population; however, the overwhelming majority remain harmless during life. Triggered by somatic or germline mutations, disease-causing adenomas manifest pathogenic mechanisms that disrupt intra-pituitary signaling to promote benign cell proliferation associated with chromosomal instability. Cellular senescence acts as a mechanistic buffer protecting against malignant transformation, an extremely rare event. It is estimated that fewer than one thousandth of all pituitary adenomas cause clinically significant disease. Adenomas variably and adversely affect morbidity and mortality depending on cell type, hormone secretory activity, and growth behavior. For most clinically apparent adenomas, multimodal therapy controlling hormone secretion and adenoma growth lead to improved quality of life and normalized mortality. The clinical biology of pituitary adenomas and particularly their benign nature stands in marked contrast to other tumors of the endocrine system such as thyroid and neuroendocrine tumors.

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Gender differences and temporal trends over two decades in acromegaly: a single center study in 112 patients

Cited by 16 publications

References 57 publications

A Pituitary Society update to acromegaly management guidelines

A Pituitary Society update to acromegaly management guidelines

Surgery for acromegaly: Indications and goals

Clinical Biology of the Pituitary Adenoma

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