Characterization of management and outcomes of patients with acromegaly in Vancouver over 30 years

Clin Invest Med. 2012 Feb 1;35(1):E27-33. doi: 10.25011/cim.v35i1.16103.

Abstract

Purpose: The purpose of this study was to characterize the management and outcomes of patients with acromegaly seen in single center in Vancouver, British Columbia, Canada over a 30 year period.

Methods: The study involved retrospective data collection from charts of patients diagnosed with acromegaly since 1980: 130 patients (63 male and 67 female) were included in the analysis, with a mean age at diagnosis of 43 years (male) and 47 years (female).

Results: The most common presenting features included acral enlargement, coarse facial features, sweating/oily skin and headache. All cases were caused by pituitary adenomas, of which 58.5% were macroadenomas and of these, 30.8% were invasive. The most common co-morbidities were hypertension 31.5%, arthralgia 28%, diabetes 27.7% and sleep apnea 23.8%. The vast majority (88.5%) of patients was treated surgically and of these patients, 21.5% also received radiotherapy and 66.9% received medical therapy. When stringent cure criteria were applied (based on latest growth hormone (GH) and IGF-1 results) the outcomes were 35.4% cured or controlled, 30% remained active, 15.4 discordant results and 19.2 % with no results reported. Twenty eight percent of patients who underwent surgery and 32% of patients who underwent radiotherapy were not cured but symptoms were moderately well controlled with medical therapy.

Conclusion: Based on the size of population studied, this study showed a prevalence of acromegaly of 29 per million. The cure rate was low following surgery but with adjuvant medical treatment disease control was achieved in most individuals.

MeSH terms

  • Acromegaly / drug therapy
  • Acromegaly / radiotherapy
  • Acromegaly / surgery
  • Acromegaly / therapy*
  • Adult
  • British Columbia
  • Female
  • Growth Hormone / therapeutic use*
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Treatment Outcome

Substances

  • Growth Hormone