Reappraisal of microscopic microsurgical transsphenoidal surgery for GH-secreting pituitary macroadenoma in patients with acromegaly: Historical data from Vietnam (2010–2013)

• Published in: Interdisciplinary neurosurgery : Advanced techniques and case management 2020-12, Vol.22, p.100811, Article 100811
• Main Authors: Hung, Ngo Manh, He, Dong Van, Kien, Vu Duy
• Format: Article
• Language: English
• Subjects: Acromegaly; Macroadenoma; Microscopic transsphenoidal surgery; Pituitary adenoma; Vietnam
• ISSN: 2214-7519; 2214-7519
• DOI: 10.1016/j.inat.2020.100811

•This study assessed outcomes of microscopic transsphenoidal surgery in patients with acromegaly.•A total of 43 patients with acromegaly resulting from Growth Hormone (GH)-secreting pituitary macroadenoma was enrolled.•The percentage of remission three months after surgery was 69.8%, with a 95% confidence interval (CI) = 53.9–82.8%.•The absence of a cavernous sinus invasion was associated with remission.•Further studies with a larger sample size should be conducted to corroborate these findings. 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. 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. 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