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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, Iría Cordido, Fernando Rodríguez Berrocal, Víctor Pascual-corrales, Eider Guerrero-pérez, Fernando Vicente, Almudena García-centeno, Rogelio González, Laura Dolores Ollero García, María Irigaray Echarri, Ana Dolores Moure Rodríguez, María Novo-rodríguez, Cristina Calatayud, María Villar-taibo, Rocío Bernabéu, Ignacio Alvarez-escola, Cristina Tenorio Jimenéz, Carmen Abellán-galiana, Pablo Venegas, Eva González-molero, Inmaculada Iglesias, Pedro Blanco, Concepción Vidal-ostos De Lara, Fernando Paz De Miguel Novoa, María López-mezquita Torres, Elena Hanzu, Felicia Lamas, Cristina Aznar Rodríguez, Silvia Aulinas, Anna María Recio, José Dolores Aviles-pérez, María Antonio Sampedro Núñez, Miguel Camara, Rosa Paja Fano, Miguel Fajardo, Carmen Cardoso, Luís Marques, Pedro Martínez-sáez, Elena Ruz-caracuel, Ignacio Marazuela, Mónica Puig-domingo, Manel |
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, issue. 7 |
URI: | https://hdl.handle.net/2445/222962 |
Related resource: | https://doi.org/10.1530/EC-25-0103 |
Appears in Collections: | Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL)) |
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ec-EC-25-0103.pdf | 460.37 kB | Adobe PDF | View/Open |
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