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65th Annual Meeting of the German Society of Neurosurgery (DGNC)

German Society of Neurosurgery (DGNC)

11 - 14 May 2014, Dresden

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Evaluation of remission rates in 173 patients with growth hormone-secreting adenomas comparing the 2000 and 2010 consensus criteria

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  • Ihsan Anik - Pituitary Research Centre, Kocaeli University and Department of Neurosurgery, School of Medicine, Kocaeli University, Kocaeli, Turkey
  • Hamza Genc - Pituitary Research Centre, Kocaeli University and Department of Neurosurgery, School of Medicine, Kocaeli University, Kocaeli, Turkey
  • Burak Cabuk - Pituitary Research Centre, Kocaeli University and Department of Neurosurgery, School of Medicine, Kocaeli University, Kocaeli, Turkey
  • Umit Celakil - Pituitary Research Centre, Kocaeli University and Department of Neurosurgery, School of Medicine, Kocaeli University, Kocaeli, Turkey
  • Kenan Koc - Pituitary Research Centre, Kocaeli University and Department of Neurosurgery, School of Medicine, Kocaeli University, Kocaeli, Turkey
  • Savas Ceylan - Pituitary Research Centre, Kocaeli University and Department of Neurosurgery, School of Medicine, Kocaeli University, Kocaeli, Turkey

Deutsche Gesellschaft für Neurochirurgie. 65. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Dresden, 11.-14.05.2014. Düsseldorf: German Medical Science GMS Publishing House; 2014. DocMO.13.03

doi: 10.3205/14dgnc076, urn:nbn:de:0183-14dgnc0762

Published: May 13, 2014

© 2014 Anik et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective: Remission rates for GH-secreting pituitary adenomas changed as random GH<1 ng/ml, GH<0.4 ng/ml under oral glucose tolerance test and normal IGF-1 values according to the 2010 criteria. In the literature, there arestill a few published data for remission rates of GH secreting adenomas considering 2010 criteria.

Method: We have performed the Endoscopic Transphenoidal (ETS) approach for 843 patients and 729 patients for pituitary adenomas between the years of 1997 (September) – 2013 (December) in the Department of Neurosurgery, Kocaeli University, Turkey. In this series, 173 patients with GH-secreting adenoma were operated on by the ETS approach. We have evaluated our remission rates comparing the 2000 and 2010 criteria retrospectively.

Results: 173 patients were included in the study, 91 (52.6%) were female and 82 (47.4%) were male. Age ranged between 18–72 years old. In this series, for the assessment of remission, the 2000 and 2010 consensus criteria were used. According to preoperative MR imagings, there were 34 (19.6%) microadenomas and 139 (80.4%) macroadenomas. Remission was achieved in 32 (94.1%) of 34 microadenomas, in 82 (59%) of 139 macroadenomas and in 114 (66%) of 173 cases altogether, according to the 2000 criteria. The remission rates were changed concerning the 2010 criteria and remission was achieved in 27 (79.4%) of 34 microadenomas, in 53 (38.1%) of 139 macroadenomas and in 85 (49.1%) of the total group of 173 pateints. There were 43 patients with Knosp 3-4 cavernous sinus invasion, and a remission was achieved in 13 (30%) patients.

Conclusions: According to the 2000 consensus criteria, our total remission rate was 66%. This rate decreased to 49.1% when avaulated according to the 2010 criteria. However, endoscopic transphenoidal technique still overrides in achieving the 2010 remission rates for GH-secreting pituitary adenomas with its detailed and panoromic vision. Furthermore, we have been performing extrapseudocapsular dissection and resection for the last 4 years and have found that this provides higher rates of remission and resection.