Assessment of Influencing Factors on Outcome of Transsphenoidal Surgery in Acromegalic Patients

Transsphenoidal surgery (TSS) is the most effective treatment for acromegalic patients, and two major factors that have been suggested as useful predictors in assessing this therapy’s success are: tumor size and preoperative basal growth hormone (GH) levels. The aim of this study was to illustrate the relationship between some predictor factors and transsphenoidal surgery (TSS) outcomes and its remission rate.Patients and A total of 20 patients underwent TSS by 4 neurosurgeons in 4 university hospitals in Tehran and were followed up for 1 year. An oral glucose tolerance test was performed at 1 week after surgery and then 3, 6, and 12 months after surgery. Moreover, Insulin Growth Factor- 1 (IGF-1) was measured at 6 and 12 months after surgery. Initial remission was observed in 7 (35%) patients with a recurrence rate of 10%. The nonresponse rate was 55%. The analysis showed a significant relationship between IGF-1 and surgery outcome in the cured patients at 6 months after surgery (P = 0.005). No significant statistical relationship was found between tumor size and the TSS outcome (P = 0.696). Given the high failure and recurrence rates following TSS in Iran, it seems important to pay more attention to diagnosing the disease earlier and improving surgical methods.