Register of sellar tumors - Reset: Diagnostics and therapy of acromegaly in Czech and Slovak Republics in the 21st century [Registr selárńich tumorü - Reset: Diagnostika a léčba akromegalie v České a Slovenské Republice v 21. století]
Hana V.,III. Interni Klinika 1. LF UK a VFN |
Svancara J.,Institute Biostatistiky a Analyz MU Brno |
Bandurova L.,III. Interni Klinika 1. LF UK a VFN |
Brabec P.,Institute Biostatistiky a Analyz MU Brno |
And 25 more authors.
Diabetologie Metabolismus Endokrinologie Vyziva | Year: 2013
Acromegaly is usually diagnosed after several years of duration. The multimodal therapy - surgery, radiotherpy, pharmacotherapy - is necessary to suppress the activity of the disease in the majority of patients. Register of sellar tumors (RESET) collecting data of patients from eight tertiary centers since the year 2000 was established in 2008 to assess the diagnostics and therapy of acromegaly in a daily practice in the Czech and Slovak Republics. Aim of analysis: diagnostics of acromegaly and effectiveness of its treatment in CR and SR in a period 1. 1. 2000-3. 9. 2013. Patients and results: 343 patients (185 + 158 from CR a SR, resp., 189 women, mean age at diagnosis 49 years). Median time of follow-up was 39.3 months. Three quarters had macroadenoma. 44% of patiens had arterial hypertension (38%) or diabetes mellitus (17%), respectively both (11%). Operated were 81% of patients (reoperated 5%). Normalised IGF-1 three months after surgery was in 54.5% of patients with microadenoma and in 42.4% with macroadenoma. Residual hormonal activity after surgery was treated in the majority of patients with combined radiotherapy and pharmacotherapy. Irradiated were 166 patients and 91% of them underwent radiosurgery with gamma-knife. Patients with operation as part of the complex therapy had faster suppression of hormonal activity. Conclusions: Acromegaly is a serious disease frequently complicated with hypertension and diabetes mellitus. 75% of patients have macroadenoma. The fastest suppression of disease activity is achieved when therapy comprise surgery, alone or in conjunction with other modalities. An individually tailored multimodal therapy is necessary in the majority of patients.