Introduction: The purpose of this study was to characterize management and outcomes of patients with acromegaly seen in single centre in Lithuania.
Methods: The study involved retrospective data collection from charts of 44 patients who were admitted to the centre between 2007 and 2012.
Results: All cases except one were caused by pituitary adenomas (61.4% macroadenomas, and 29.5% microadenomas). The most common co-morbidities were nodular thyroid disease (86.4%), hypertension (86.4%), and IGT or type 2 DM (45.5%). Transsphenoidal operation was applied as the first-line therapy in 65.9% of patients and led to disease remission in 48.3%. Primary medical therapy was administered in 25.0% of cases. Of surgically treated patients, 51.7% were diagnosed with desease recurrence and received medical therapy with somatostatin analogs, cabergoline or bromocriptine. Radiotherapy as a third-line treatment was applied in the 17.2% of patients. Based on the latest GH and IGF1 results, the outcomes were: 38.1% controlled, 28.6% partially controlled, and 33.3% uncontrolled. Control and partial control were achieved in 18.2 and 27.3% of cases in primary medical therapy group, and in 13.3 and 40.0% of cases in combined therapy group. Mean observational period IGF1 in the primary medical treatment group (672.8±206.4 μg/l) was not statistically different from combined treatment group (556.4±259.4 μg/l, P=0.139). We observed stronger correlation of IGF1 and GH in samples taken without medical therapy (rs=0.667) than in those taken while on SSA treatment (rs=0.416). GH, gender and age, but not SSA treatment, were significant determinants of IGF1 level in regression analysis.
Conclusions: Control of the disease remains a challenge despite availability of transsphenoidal surgery, SSA, dopamine agonists and conventional radiotherapy. The influence of SSA on IGF1 level remains to be further studied.