Surgical treatment and clinical outcome of GH-secreting adenomas in elderly patients

G. Minniti, M. L. Jaffrain-Rea, V. Esposito, A. Santoro, C. Moroni, J. Lenzi, G. Tamburrano, R. Cassone, G. Cantore

Research output: Contribution to journalArticle

Abstract

Patients older than 65 years represent 3-5% of all acromegalic patients. The old age of the patients and the higher incidence of cardiovascular and metabolic complications related to acromegaly could increase the intra- and peri-operative risk, so that medical treatment is usually recommended as a therapy of choice. The aim of this retrospective study was to investigate the impact of trans-sphenoidal surgery in a series of 22 elderly patients with active acromegaly, with special regard to anaesthesiological risk, peri-operative complications, and clinical outcome. Despite an increased anesthesiological risk being present in 16/22 patients, no complication occurred during surgery. Similarly, no post-operative mortality or major complications were observed. Biochemical cure, defined at 6 months by glucose-suppressed plasma GH levels below 1 ng/ml and normal age-corrected IGF-I value levels, was achieved in 68% of patients and no recurrence of disease was observed in the subsequent follow-up (mean 5.2 ± 2.1 years). A significant cardiovascular improvement was observed in cured patients, with a decrease of left ventricular mass index (91.3 ± 20.1 vs 115.9 ± 15.0 g/m2; P <0.005), as measured by echocardiography, as well as a slight but significant decrease of systolic and diastolic blood pressure values (130.0 ± 12.1 mmHg vs 137.6 ± 13.5 mmHg P <0.05; and 84.2 ± 6.4 mmHg vs 88.8 ± 7.5 mmHg P <0.05, respectively). A significant post-operative improvement of glucose tolerance was also observed in this group. We conclude that transsphenoidal surgery, if well planned and carefully performed, is safe and able to induce a significant cardiovascular and metabolic improvement even in elderly acromegalic patients.

Original languageEnglish
Pages (from-to)1205-1211
Number of pages7
JournalActa Neurochirurgica
Volume143
Issue number12
DOIs
Publication statusPublished - 2001

Fingerprint

Adenoma
Acromegaly
Blood Pressure
Glucose
Insulin-Like Growth Factor I
Echocardiography
Retrospective Studies
Recurrence
Mortality
Incidence
Therapeutics

Keywords

  • Acromegaly
  • Aging
  • Transsphenoidal surgery

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Minniti, G., Jaffrain-Rea, M. L., Esposito, V., Santoro, A., Moroni, C., Lenzi, J., ... Cantore, G. (2001). Surgical treatment and clinical outcome of GH-secreting adenomas in elderly patients. Acta Neurochirurgica, 143(12), 1205-1211. https://doi.org/10.1007/s007010100015

Surgical treatment and clinical outcome of GH-secreting adenomas in elderly patients. / Minniti, G.; Jaffrain-Rea, M. L.; Esposito, V.; Santoro, A.; Moroni, C.; Lenzi, J.; Tamburrano, G.; Cassone, R.; Cantore, G.

In: Acta Neurochirurgica, Vol. 143, No. 12, 2001, p. 1205-1211.

Research output: Contribution to journalArticle

Minniti, G, Jaffrain-Rea, ML, Esposito, V, Santoro, A, Moroni, C, Lenzi, J, Tamburrano, G, Cassone, R & Cantore, G 2001, 'Surgical treatment and clinical outcome of GH-secreting adenomas in elderly patients', Acta Neurochirurgica, vol. 143, no. 12, pp. 1205-1211. https://doi.org/10.1007/s007010100015
Minniti, G. ; Jaffrain-Rea, M. L. ; Esposito, V. ; Santoro, A. ; Moroni, C. ; Lenzi, J. ; Tamburrano, G. ; Cassone, R. ; Cantore, G. / Surgical treatment and clinical outcome of GH-secreting adenomas in elderly patients. In: Acta Neurochirurgica. 2001 ; Vol. 143, No. 12. pp. 1205-1211.
@article{69ec83ca15f8426aa81b86f771e6ea43,
title = "Surgical treatment and clinical outcome of GH-secreting adenomas in elderly patients",
abstract = "Patients older than 65 years represent 3-5{\%} of all acromegalic patients. The old age of the patients and the higher incidence of cardiovascular and metabolic complications related to acromegaly could increase the intra- and peri-operative risk, so that medical treatment is usually recommended as a therapy of choice. The aim of this retrospective study was to investigate the impact of trans-sphenoidal surgery in a series of 22 elderly patients with active acromegaly, with special regard to anaesthesiological risk, peri-operative complications, and clinical outcome. Despite an increased anesthesiological risk being present in 16/22 patients, no complication occurred during surgery. Similarly, no post-operative mortality or major complications were observed. Biochemical cure, defined at 6 months by glucose-suppressed plasma GH levels below 1 ng/ml and normal age-corrected IGF-I value levels, was achieved in 68{\%} of patients and no recurrence of disease was observed in the subsequent follow-up (mean 5.2 ± 2.1 years). A significant cardiovascular improvement was observed in cured patients, with a decrease of left ventricular mass index (91.3 ± 20.1 vs 115.9 ± 15.0 g/m2; P <0.005), as measured by echocardiography, as well as a slight but significant decrease of systolic and diastolic blood pressure values (130.0 ± 12.1 mmHg vs 137.6 ± 13.5 mmHg P <0.05; and 84.2 ± 6.4 mmHg vs 88.8 ± 7.5 mmHg P <0.05, respectively). A significant post-operative improvement of glucose tolerance was also observed in this group. We conclude that transsphenoidal surgery, if well planned and carefully performed, is safe and able to induce a significant cardiovascular and metabolic improvement even in elderly acromegalic patients.",
keywords = "Acromegaly, Aging, Transsphenoidal surgery",
author = "G. Minniti and Jaffrain-Rea, {M. L.} and V. Esposito and A. Santoro and C. Moroni and J. Lenzi and G. Tamburrano and R. Cassone and G. Cantore",
year = "2001",
doi = "10.1007/s007010100015",
language = "English",
volume = "143",
pages = "1205--1211",
journal = "Acta Neurochirurgica",
issn = "0001-6268",
publisher = "Springer Wien",
number = "12",

}

TY - JOUR

T1 - Surgical treatment and clinical outcome of GH-secreting adenomas in elderly patients

AU - Minniti, G.

AU - Jaffrain-Rea, M. L.

AU - Esposito, V.

AU - Santoro, A.

AU - Moroni, C.

AU - Lenzi, J.

AU - Tamburrano, G.

AU - Cassone, R.

AU - Cantore, G.

PY - 2001

Y1 - 2001

N2 - Patients older than 65 years represent 3-5% of all acromegalic patients. The old age of the patients and the higher incidence of cardiovascular and metabolic complications related to acromegaly could increase the intra- and peri-operative risk, so that medical treatment is usually recommended as a therapy of choice. The aim of this retrospective study was to investigate the impact of trans-sphenoidal surgery in a series of 22 elderly patients with active acromegaly, with special regard to anaesthesiological risk, peri-operative complications, and clinical outcome. Despite an increased anesthesiological risk being present in 16/22 patients, no complication occurred during surgery. Similarly, no post-operative mortality or major complications were observed. Biochemical cure, defined at 6 months by glucose-suppressed plasma GH levels below 1 ng/ml and normal age-corrected IGF-I value levels, was achieved in 68% of patients and no recurrence of disease was observed in the subsequent follow-up (mean 5.2 ± 2.1 years). A significant cardiovascular improvement was observed in cured patients, with a decrease of left ventricular mass index (91.3 ± 20.1 vs 115.9 ± 15.0 g/m2; P <0.005), as measured by echocardiography, as well as a slight but significant decrease of systolic and diastolic blood pressure values (130.0 ± 12.1 mmHg vs 137.6 ± 13.5 mmHg P <0.05; and 84.2 ± 6.4 mmHg vs 88.8 ± 7.5 mmHg P <0.05, respectively). A significant post-operative improvement of glucose tolerance was also observed in this group. We conclude that transsphenoidal surgery, if well planned and carefully performed, is safe and able to induce a significant cardiovascular and metabolic improvement even in elderly acromegalic patients.

AB - Patients older than 65 years represent 3-5% of all acromegalic patients. The old age of the patients and the higher incidence of cardiovascular and metabolic complications related to acromegaly could increase the intra- and peri-operative risk, so that medical treatment is usually recommended as a therapy of choice. The aim of this retrospective study was to investigate the impact of trans-sphenoidal surgery in a series of 22 elderly patients with active acromegaly, with special regard to anaesthesiological risk, peri-operative complications, and clinical outcome. Despite an increased anesthesiological risk being present in 16/22 patients, no complication occurred during surgery. Similarly, no post-operative mortality or major complications were observed. Biochemical cure, defined at 6 months by glucose-suppressed plasma GH levels below 1 ng/ml and normal age-corrected IGF-I value levels, was achieved in 68% of patients and no recurrence of disease was observed in the subsequent follow-up (mean 5.2 ± 2.1 years). A significant cardiovascular improvement was observed in cured patients, with a decrease of left ventricular mass index (91.3 ± 20.1 vs 115.9 ± 15.0 g/m2; P <0.005), as measured by echocardiography, as well as a slight but significant decrease of systolic and diastolic blood pressure values (130.0 ± 12.1 mmHg vs 137.6 ± 13.5 mmHg P <0.05; and 84.2 ± 6.4 mmHg vs 88.8 ± 7.5 mmHg P <0.05, respectively). A significant post-operative improvement of glucose tolerance was also observed in this group. We conclude that transsphenoidal surgery, if well planned and carefully performed, is safe and able to induce a significant cardiovascular and metabolic improvement even in elderly acromegalic patients.

KW - Acromegaly

KW - Aging

KW - Transsphenoidal surgery

UR - http://www.scopus.com/inward/record.url?scp=0035659649&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0035659649&partnerID=8YFLogxK

U2 - 10.1007/s007010100015

DO - 10.1007/s007010100015

M3 - Article

C2 - 11810383

AN - SCOPUS:0035659649

VL - 143

SP - 1205

EP - 1211

JO - Acta Neurochirurgica

JF - Acta Neurochirurgica

SN - 0001-6268

IS - 12

ER -