| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH |
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Submitted on May 5, 2005
Accepted on August 15, 2005
Departments of Medicine, Laboratory Medicine & Pathobiology, University of Toronto; Mount Sinai Hospital, St. Michael's Hospital and University Health Network; Ontario Cancer Institute and the Freeman Centre for Endocrine Oncology, Toronto, Ontario, Canada M5G-1X5
* To whom correspondence should be addressed. E-mail: sezzat{at}mtsinai.on.ca.
Context: Persistently elevated growth hormone (GH) and insulin-like growth factor I (IGF-I) levels are associated with increased mortality. Response to somatostatin analogs (SSA) is variable. Objective: To examine the significance of somatotroph adenoma type on response to SSA. Design: Retrospective examination of postoperatively treated acromegalic patients with the SSA octreotide. Setting: University-affiliated tertiary care center. Patients: 40 patients with acromegaly. Main outcome measures: Normalization of IGF-I levels and GH responses. Results: Univariate analysis revealed that responders were more likely to have densely granulated somatotroph adenomas (80% vs. 43.8%; P = 0.024), to be older (51.3 vs. 38.2 yr; P < 0.003), to have smaller tumors (stage 
3 (78.6% vs. 35.7%, P = 0.022)), have lower baseline IGF-I (453 vs. 716 µg/L; P < 0.001) and GH levels (2.7 vs. 7.8 µg/L; P < 0.05), and require lower maximum dose of SSA (24 vs. 31 mg q 4 weeks; P = 0.013). Multivariate analysis confirmed that a densely granulated adenoma was strongest predictor of complete response (adjusted odds ratio (OR) 58.41 (95% confidence interval (CI): 1.24-1000.00); P = 0.04) compared with other covariates including older age at time of diagnosis (OR 1.15 per year, (95% CI: 1.01-1.31); P = 0.03), and tumor stage 3 (OR 29.77 (95% CI 1.01-885.45), P < 0.05). Conclusions: Somatotroph tumor type represents a strong clinical predictor of response to SSA treatment and will help to identify patients warranting more vigilant management of their disease.
This article has been cited by other articles:
 |
|
 |
|
  A. Fusco, M. C. Zatelli, A. Bianchi, V. Cimino, L. Tilaro, F. Veltri, F. Angelini, L. Lauriola, V. Vellone, F. Doglietto, et al. Prognostic Significance of the Ki-67 Labeling Index in Growth Hormone-Secreting Pituitary Adenomas J. Clin. Endocrinol. Metab., July 1, 2008; 93(7): 2746 - 2750. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. A. Leontiou, M. Gueorguiev, J. van der Spuy, R. Quinton, F. Lolli, S. Hassan, H. S. Chahal, S. C. Igreja, S. Jordan, J. Rowe, et al. The Role of the Aryl Hydrocarbon Receptor-Interacting Protein Gene in Familial and Sporadic Pituitary Adenomas J. Clin. Endocrinol. Metab., June 1, 2008; 93(6): 2390 - 2401. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. L. Asa, R. DiGiovanni, J. Jiang, M. L. Ward, K. Loesch, S. Yamada, T. Sano, K. Yoshimoto, S. J. Frank, and S. Ezzat A Growth Hormone Receptor Mutation Impairs Growth Hormone Autofeedback Signaling in Pituitary Tumors Cancer Res., August 1, 2007; 67(15): 7505 - 7511. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N Y Y Al-Brahim and S L Asa My approach to pathology of the pituitary gland J. Clin. Pathol., December 1, 2006; 59(12): 1245 - 1253. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH |
| Endocrinology | Endocrine Reviews | J. Clin. End. & Metab. |
| Molecular Endocrinology | Recent Prog. Horm. Res. | All Endocrine Journals |
