Reappraisal of microscopic microsurgical transsphenoidal surgery for GH-secreting pituitary macroadenoma in patients with acromegaly: Historical data from Vietnam (2010–2013)
Objective: In Vietnam, microscopic transsphenoidal surgery has been implemented to treat acromegaly patients since 2000. However, no specific outcome studies have been conducted. We assess outcomes of this technique and factors associated with remission. Methods: This prospective observational study...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2020-12-01
|
| Series: | Interdisciplinary Neurosurgery |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2214751920303728 |
| _version_ | 1818262155360731136 |
|---|---|
| author | Ngo Manh Hung Dong Van He Vu Duy Kien |
| author_facet | Ngo Manh Hung Dong Van He Vu Duy Kien |
| author_sort | Ngo Manh Hung |
| collection | DOAJ |
| description | Objective: In Vietnam, microscopic transsphenoidal surgery has been implemented to treat acromegaly patients since 2000. However, no specific outcome studies have been conducted. We assess outcomes of this technique and factors associated with remission. Methods: This prospective observational study was conducted in 43 patients with acromegaly resulting from Growth Hormone (GH)-secreting pituitary macroadenoma. The primary outcome of interest was remission status, as defined by random GH levels below 2.5 ng/mL and Insulin-like Growth Factor-1 (IGF-1) within the normal range three months post-operation. Results: The proportion of patients with remission three months after surgery was 69.8% with a 95% confidence interval (CI) = 53.9–82.8%. The proportions of residual tumors three months after surgery in the remission and non-remission groups were 10.0% (3/27) and 23.1% (3/10), respectively, but there was no significant difference between these proportions (Fisher's exact test, p = 0.35). In a multivariate logistic regression analysis adjusted for sex and age, remission was associated with the absence of cavernous sinus invasion, with an odds ratio (OR) = 5.2 (95% CI = 1.1–26.5). In addition, remission was also associated with a post-operative GH level < 2.5 ng/mL (OR = 7.4, 95% CI = 1.1–48.0). Conclusion: We report that the proportion of patients with disease remission three months after surgery was high, indicating that microscopic transsphenoidal surgery was efficacious. More studies should be conducted to assess outcomes of various acromegaly treatment methods in the current context of Vietnam. |
| first_indexed | 2024-12-12T18:58:38Z |
| format | Article |
| id | doaj.art-9b0614b8f5034e10a6ff03f9026dcd36 |
| institution | Directory Open Access Journal |
| issn | 2214-7519 |
| language | English |
| last_indexed | 2024-12-12T18:58:38Z |
| publishDate | 2020-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Interdisciplinary Neurosurgery |
| spelling | doaj.art-9b0614b8f5034e10a6ff03f9026dcd362022-12-22T00:15:10ZengElsevierInterdisciplinary Neurosurgery2214-75192020-12-0122100811Reappraisal of microscopic microsurgical transsphenoidal surgery for GH-secreting pituitary macroadenoma in patients with acromegaly: Historical data from Vietnam (2010–2013)Ngo Manh Hung0Dong Van He1Vu Duy Kien2Department of Neurosurgery 2, Viet Duc Hospital, Hanoi, Viet Nam; Corresponding author at: Department of Neurosurgery 2, Viet Duc Hospital, Hanoi, Vietnam 40 Trang Thi, Hoan Kiem, Hanoi, Viet Nam.Department of Neurosurgery 1, Viet Duc Hospital, Hanoi, Viet NamOnCare Medical Technology Company Limited, Hanoi, Viet NamObjective: In Vietnam, microscopic transsphenoidal surgery has been implemented to treat acromegaly patients since 2000. However, no specific outcome studies have been conducted. We assess outcomes of this technique and factors associated with remission. Methods: This prospective observational study was conducted in 43 patients with acromegaly resulting from Growth Hormone (GH)-secreting pituitary macroadenoma. The primary outcome of interest was remission status, as defined by random GH levels below 2.5 ng/mL and Insulin-like Growth Factor-1 (IGF-1) within the normal range three months post-operation. Results: The proportion of patients with remission three months after surgery was 69.8% with a 95% confidence interval (CI) = 53.9–82.8%. The proportions of residual tumors three months after surgery in the remission and non-remission groups were 10.0% (3/27) and 23.1% (3/10), respectively, but there was no significant difference between these proportions (Fisher's exact test, p = 0.35). In a multivariate logistic regression analysis adjusted for sex and age, remission was associated with the absence of cavernous sinus invasion, with an odds ratio (OR) = 5.2 (95% CI = 1.1–26.5). In addition, remission was also associated with a post-operative GH level < 2.5 ng/mL (OR = 7.4, 95% CI = 1.1–48.0). Conclusion: We report that the proportion of patients with disease remission three months after surgery was high, indicating that microscopic transsphenoidal surgery was efficacious. More studies should be conducted to assess outcomes of various acromegaly treatment methods in the current context of Vietnam.http://www.sciencedirect.com/science/article/pii/S2214751920303728Microscopic transsphenoidal surgeryAcromegalyPituitary adenomaMacroadenomaVietnam |
| spellingShingle | Ngo Manh Hung Dong Van He Vu Duy Kien Reappraisal of microscopic microsurgical transsphenoidal surgery for GH-secreting pituitary macroadenoma in patients with acromegaly: Historical data from Vietnam (2010–2013) Interdisciplinary Neurosurgery Microscopic transsphenoidal surgery Acromegaly Pituitary adenoma Macroadenoma Vietnam |
| title | Reappraisal of microscopic microsurgical transsphenoidal surgery for GH-secreting pituitary macroadenoma in patients with acromegaly: Historical data from Vietnam (2010–2013) |
| title_full | Reappraisal of microscopic microsurgical transsphenoidal surgery for GH-secreting pituitary macroadenoma in patients with acromegaly: Historical data from Vietnam (2010–2013) |
| title_fullStr | Reappraisal of microscopic microsurgical transsphenoidal surgery for GH-secreting pituitary macroadenoma in patients with acromegaly: Historical data from Vietnam (2010–2013) |
| title_full_unstemmed | Reappraisal of microscopic microsurgical transsphenoidal surgery for GH-secreting pituitary macroadenoma in patients with acromegaly: Historical data from Vietnam (2010–2013) |
| title_short | Reappraisal of microscopic microsurgical transsphenoidal surgery for GH-secreting pituitary macroadenoma in patients with acromegaly: Historical data from Vietnam (2010–2013) |
| title_sort | reappraisal of microscopic microsurgical transsphenoidal surgery for gh secreting pituitary macroadenoma in patients with acromegaly historical data from vietnam 2010 2013 |
| topic | Microscopic transsphenoidal surgery Acromegaly Pituitary adenoma Macroadenoma Vietnam |
| url | http://www.sciencedirect.com/science/article/pii/S2214751920303728 |
| work_keys_str_mv | AT ngomanhhung reappraisalofmicroscopicmicrosurgicaltranssphenoidalsurgeryforghsecretingpituitarymacroadenomainpatientswithacromegalyhistoricaldatafromvietnam20102013 AT dongvanhe reappraisalofmicroscopicmicrosurgicaltranssphenoidalsurgeryforghsecretingpituitarymacroadenomainpatientswithacromegalyhistoricaldatafromvietnam20102013 AT vuduykien reappraisalofmicroscopicmicrosurgicaltranssphenoidalsurgeryforghsecretingpituitarymacroadenomainpatientswithacromegalyhistoricaldatafromvietnam20102013 |