This Article Full Text Full Text (PDF) All Versions of this Article: 93/8/2984    most recent Author Manuscript (PDF) Submit a related Letter to the Editor Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Copyright Permission Citing Articles Citing Articles via HighWire Google Scholar Articles by Carlsen, S. M. PubMed PubMed Citation Articles by Carlsen, S. M. Related Collections Neuroendocrinology and Pituitary Endocrine Oncology

Preoperative Octreotide Treatment in Newly Diagnosed Acromegalic Patients with Macroadenomas Increases Cure Short-Term Postoperative Rates: A Prospective, Randomized Trial

Department of Laboratory Medicine (S.M.C.), Childrens and Womens Health, Norwegian University for Science and Technology, 7491 Trondheim, Norway; Department of Endocrinology (S.M.C.), St. Olavs Hospital, 7006 Trondheim, Norway; Department of Neurosurgery (M.L.-J.), Endocrinology Unit (S.A.), Department of Medicine, Haukeland University Hospital and Institute of Medicine, University of Bergen, N-5021 Bergen, Norway; Neurosurgery Unit (M.L.-J.), Institute of Surgical Sciences, University of Bergen, N-5007 Bergen, Norway; Endocrinology Unit (T.S., S.L.F., J.B.), Department of Medicine, Department of Radiology (J.K.H.), Rikshospitalet-Radiumhospitalet Medical Center, 0027 Oslo, Norway; Endocrinology Unit (Ø.J.), Department of Medicine, Aker University Hospital, 0514 Oslo, Norway; Endocrinology Unit (J.S.), Department of Medicine, University Hospital of North Norway, 9038 Tromsø, Norway; Institute of Clinical Medicine (J.S.), University of Tromsø, 9037 Tromsø, Norway; Endocrinology Unit (J.G.C.), Department of Medicine, Stavanger University Hospital, N-4068 Stavanger, Norway; and Research Institute for Internal Medicine (S.L.F., J.B.), University of Oslo, NO-0318 Oslo, Norway

Address all correspondence and requests for reprints to: Sven M. Carlsen, Department of Endocrinology, St. Olavs Hospital, University Hospital of Trondheim, 7006 Trondheim, Norway. E-mail: sven.carlsen{at}ntnu.no.

Context: Surgery is the primary treatment of acromegaly. However, it often fails to cure the patient. New strategies that improve surgical outcome are needed.

Objective: Our objective was to investigate whether 6-month preoperative treatment with octreotide improves the surgical outcome in newly diagnosed acromegalic patients.

Patients: During a 5-yr period (1999–2004), all newly diagnosed acromegalic patients between 18 and 80 yr of age in Norway were screened and invited to participate in the study. A total of 62 patients was included in the Preoperative Octreotide Treatment of Acromegaly study.

Research Design and Methods: After a baseline evaluation, patients were randomized directly to transsphenoidal surgery (n = 30) or pretreatment with octreotide (n = 32) 20 mg im every 28th day for 6 months before transsphenoidal surgery. Cure was evaluated 3 months postoperatively primarily by IGF-I levels.

Results: According to the IGF-I criteria, 14 of 31 (45%) pretreated patients vs. seven of 30 (23%) patients with direct surgery were cured by surgery (P = 0.11). In patients with microadenomas (10 mm), one of five (20%) pretreated vs. three of five (60%) with direct surgery were cured (P = 0.52). In patients with macroadenomas, 13 of 26 (50%) pretreated vs. four of 25 (16%) with direct surgery were cured (P = 0.017).

Conclusions: Six-month preoperative octreotide treatment might improve surgical cure rate in newly diagnosed acromegalic patients with macroadenomas. These results have to be confirmed in future studies.

This article has been cited by other articles:

				A. Beckers Does Preoperative Somatostatin Analog Treatment Improve Surgical Cure Rates in Acromegaly? A New Look at an Old Question J. Clin. Endocrinol. Metab., August 1, 2008; 93(8): 2975 - 2977. [Full Text] [PDF]