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Recurrent Acromegaly: A Systematic Review on Therapeutic Approaches Publisher Pubmed



Maroufi SF1, 2 ; Sabahi M3 ; Aarabi SS2 ; Samadian M4 ; Dabecco R3 ; Adada B3 ; Arce KM5 ; Borgheirazavi H3, 6
Authors
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Authors Affiliations
  1. 1. Neurosurgery Research Network (NRN), Universal Scientific Education and Research Network (USERN), Tehran, Iran
  2. 2. Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Department of Neurological Surgery, Pauline Braathen Neurological Centre, Cleveland Clinic Florida, Weston, FL, United States
  4. 4. Department of Neurosurgery, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  5. 5. Department of Endocrinology Diabetes and Metabolism, Cleveland Clinic Florida, Weston, FL, United States
  6. 6. Department of Neurological Surgery, Pauline Braathen Neurological Centre, 2950 Cleveland Clinic Blvd., Weston, 33331, FL, United States

Source: BMC Endocrine Disorders Published:2024


Abstract

Background and objective: Management of recurrent acromegaly is challenging for both neurosurgeons and endocrinologists. Several treatment options including repeat surgery, medical therapy, and radiation are offered for such patients. The efficacy of these modalities for the treatment of recurrence has not been studied previously in the literature. In this study, we aim to systematically review the existing cases of recurrence and come to a conclusion regarding the appropriate treatment in such cases. Method: A systematic review was performed through PubMed, Scopus, Web of Science, and Cochrane database to identify studies reporting the treatment outcome of recurrent acromegaly patients. Using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, the included studies were reviewed for primary and secondary treatment, complications, and outcomes of the secondary treatment. Results: The systematic review retrieved 23 records with 95 cases of recurrent acromegaly. The mean time of recurrence was 4.16 years after the initial treatment. The most common primary treatment was surgery followed by radiotherapy. The remission rate was significantly higher in medical and radiotherapy compared to surgical treatment. Conclusion: In cases of recurrent acromegaly, the patient may benefit more from radiotherapy and medical therapy compared to surgery. As the quality of evidence is low on this matter feature studies specifically designed for recurrent patients are needed. © 2024, The Author(s).
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