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document
Preoperative lanreotide treatment in acromegalic patients with macroadenomas increases short-term postoperative cure rates : a prospective , randomised trial . OBJECTIVE To investigate whether 4-month preoperative lanreotide treatment would improve the surgical cure rate of newly diagnosed acromegalic patients with macroadenomas . DESIGN A prospective , randomised study . METHODS After a baseline evaluation , patients were randomly assigned to 4-month preoperative treatment with lanreotide ( starting with 30 mg/2 weeks i.m . and increasing to 30 mg/week i.m . at week 8 if mean GH > 2.5 microg/l on GH day curves ; pretreatment group , Group 1 ) or to transsphenoidal surgery ( direct surgery group , Group 2 ) . Cure was evaluated 4 months postoperatively primarily by fasting IGF1 less than or equal to age-adjusted upper limit of normal . RESULTS A pool of 108 patients was randomly divided into two groups . Five patients in each group were lost to follow-up during the study period , so 49 patients in each group were analysed . At baseline , no difference was observed between the two groups . Cure was established in 24 of 49 ( 49.0 % , 95 % confidence interval ( CI ) , 35.0-63.0 % ) pretreated patients ( Group 1 ) versus 9 of 49 ( 18.4 % , 95 % CI , 7.6-29.2 % ) direct surgery patients ( Group 2 ; P=0.001 ) . Surgical morbidity was recorded in 12 patients ( 12.2 % ) and was similar in Group 1 and 2 patients ( 14.3 and 10.2 % respectively ; P=0.538 ) . The postoperative hospital stay was similar between groups : being 4.5+/-1.6 days in Group 1 vs 4.8+/-1.9 days in Group 2 ( P=0.328 ) . CONCLUSIONS Pretreatment with lanreotide before transsphenoidal surgery improves surgical cure rates in patients with GH-secreting pituitary macroadenomas . Pretreatment does not affect surgical complications or duration of hospital stay ( ClinicalTrials.gov number , NCT00993356 ) .
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Intervention_Pharmacological
lanreotide
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Intervention_Pharmacological
lanreotide
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Intervention_Surgical
transsphenoidal surgery
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Intervention_Pharmacological
lanreotide
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Outcome_Other
surgical cure rate
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Outcome_Other
Cure
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Outcome_Other
Cure
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Outcome_Physical
Surgical morbidity
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Outcome_Other
postoperative hospital stay
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Outcome_Other
surgical cure rates
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Outcome_Adverse-effects
surgical complications
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Outcome_Other
duration of hospital stay
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Participant_Condition
acromegalic patients with macroadenomas
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Participant_Condition
newly diagnosed acromegalic patients with macroadenomas
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Participant_Sample-size
108 patients
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Participant_Sample-size
49 patients in each group
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Participant_Condition
patients with GH-secreting pituitary macroadenomas