Acromegaly is a relatively rare disorder with a prevalence of 40 per million. Diagnostic and management process have evolved with time, however lack of statistical facts/data remained an issue.
Aims: 1) To look at the cohort of patients who attend our local Endocrine department with a diagnosis of acromegaly. 2) To determine how many are cured with surgery, how many need adjuvant treatment and how many remain uncontrolled despite all treatment modalities. 3) Assess whether there is any biochemical or anatomical differences in how the patients in different groups initially present.
Methods: Data was collected retrospectively through a search on our trust electronic records- DIABETA3, ICE, EPRO and also patient notes. We identified 48 patients (26 male, 22 female) diagnosed between 1976 and 2018 Our local district general hospital covers a population of 675,000. IGF-1 and Growth hormone profile were available in 38 patients. There is no correlation between initial IGF-1 levels and cure rates. Only 6 patients were on hydrocortisone, 2 on thyroxine and 8 on testosterone replacement at diagnosis. 40 patients underwent surgery (23 male, 17 female). Surgery was curative in 15 patients (7 male, 8 female). Full data was available on 13 patients. 6 patients were cured (3 macro, 3 microadenoma) 7 patients were not cured (5 macro, 2 microadenoma). Tumour size does not appear to influence surgical outcome. As per all retrospective studies, our data collection was limited by missing biochemistry records, unrecorded diagnosis and patients who were diagnosed at the pre electronic database era.
Conclusion: This is one of few studies reporting key results on epidemiology, treatment options, surgical outcomes, long term mortality and morbidity. Post auditing, we have now set up a dedicated Acromegaly clinic to monitor these cohort of patients with a life-long condition. It also allows better understanding and interactions among patients with Acromegaly.