Please use this identifier to cite or link to this item:
https://hdl.handle.net/2445/222962
Title: | Predictors of therapeutic failure in GH and prolactin co-secreting pituitary adenomas |
Author: | Araujo Castro, Marta Biagetti, Betina Menéndez, Edelmiro Novoa Testa, Iria Cordido, Fernando Rodríguez Berrocal, Víctor Pascual Corrales, Eider Guerrero Pérez, Fernando Vicente, Almudena García Centeno, Rogelio González Fernández, Laura Ollero García, María Dolores Irigaray Echarri, Ana Moure Rodríguez, María Dolores Novo Rodríguez, Cristina Calatayud, María Villar Taibo, Rocío Bernabéu, Ignacio Álvarez Escolá, Cristina Tenorio Jimenéz, Carmen Abellán Galiana, Pablo Venegas Moreno, Eva González Molero, Inmaculada Iglesias, Pedro Blanco, Concepción Vidal Ostos de Lara, Fernando Miguel Novoa, María de la Paz de López Mezquita Torres, Elena Hanzu, Felicia A. Lamas, Cristina Aznar Rodríguez, Silvia Aulinas, Anna Recio Córdova, Jose M. Aviles Pérez, María Dolores Sampedro Nuñez, Miguel Antonio Cámara, Rosa Paja Fano, Miguel Fajardo Montañana, Carmen Cardoso, Luís Marques, Pedro Martínez Sáez, Elena Ruz Caracuel, Ignacio Marazuela, Mónica Puig Domingo, Manuel |
Keywords: | Malalties de la hipòfisi Cirurgia endocrina Terapèutica Pituitary gland diseases Endocrine surgery Therapeutics |
Issue Date: | 1-Jul-2025 |
Publisher: | Bioscientifica |
Abstract: | Aim: To evaluate which factors are associated with a higher probability of failure to surgical and first-generation somatostatin receptor ligands (fgSRLs) treatment in patients with growth hormone and prolactin co-secreting pituitary adenomas (GH&PRL-PAs). Methods: Acromegaly patients with GH&PRL-PAs included in the ACRO-SPAIN study were enrolled. GH&PRL-PAs were defined as tumors with serum PRL levels above the upper limit of normal and positive immunostaining for GH and PRL, or with PRL levels >= 100 ng/mL when immunostaining data were not available. Results: A total of 126 acromegaly patients with GH&PRL-PAs who underwent transsphenoidal pituitary surgery were included, and 42.1% (n = 53) were biochemically cured at the immediate postoperative evaluation. Knosp grade >2 (odds ratio (OR) 3.48, 95% CI 1.28-9.38), higher serum GH (OR 1.01, 95% CI 1.01-1.08) and IGF-1 (OR 1.60, 95% CI 1.05-2.45) levels were associated with a lower probability of surgical cure. Sixty-eight patients received first-line medical therapy as follows: fgSRLs in monotherapy (n = 22), fgSRL plus cabergoline (n = 37), cabergoline in monotherapy (n = 7) and pegvisomant in monotherapy (n = 2). Among the cases treated with fgSRL in monotherapy, 18.2% (n = 4/22) were resistant. We identified as predictors of fgSRL resistance (in monotherapy and combined with cabergoline) a Knosp grade >2 (OR 8.75, P = 0.003), high GH levels at acromegaly diagnosis (OR 1.02, P = 0.031) and higher postoperative GH levels (OR 1.05, P = 0.006), but no predictors of response to fgSRL in monotherapy were identified. Conclusion: The clinical predictors of surgical failure and of fgSRL resistance in patients with GH&PRL-PAs are similar to those described in acromegaly without PRL, co-secretion. |
Note: | Reproducció del document publicat a: https://doi.org/10.1530/EC-25-0103 |
It is part of: | Endocrine Connections, 2025, vol. 14, num. 7 |
URI: | https://hdl.handle.net/2445/222962 |
Related resource: | https://doi.org/10.1530/EC-25-0103 |
ISSN: | 2049-3614 |
Appears in Collections: | Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL)) |
Files in This Item:
File | Description | Size | Format | |
---|---|---|---|---|
ec-EC-25-0103.pdf | 460.37 kB | Adobe PDF | View/Open |
This item is licensed under a
Creative Commons License