Results of surgical and somatostatin analogue therapy and their combination in acromegaly – A Retrospective Analysis of the German Acromegaly Register

Background: Data on surgical and medical treatment outcome in acromegaly mostly originate from specialized centres. We retrospectively analysed data on surgery, primary somatostatin analogue therapy (SSA), surgery preceded by SSA and SSA preceded by surgery in 1485 patients from the German Acromegaly Register. Methods: Two trained nurses visited all centres (N=42) for data acquisition. Results: Primary surgery: Of 889 patients 554 yielded analyzable data (microadenomas 22.9%, macroadenoms 77.1%). GH and IGF-I normalized in 54.3 and 67.2%. Partial or total pituitary insufficiency occurred in 28.6 % initially and 41.2 % post surgery. Primary SSA (3 months): Of 329 patients 145 yielded analyzable data (microadenomas 26.7%, macroadenoms 73.3%). GH and IGF-I normalized in 36.3 and 30.5%, increasing to 40.8 and 41.5 % with longer SSA (360 days) in 54 patients. Pituitary function did not change. SSA (3 months) prior to surgery: Of 234 patients 93 yielded analyzable data. Post-surgery GH and IGF-