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Browsing by Author "Vicente, Almudena"

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  • Predictors of therapeutic failure in GH and prolactin co-secreting pituitary adenomas
    Publication . Araujo-Castro, Marta; Biagetti, Betina; Menéndez, Edelmiro; Novoa-Testa, Iría; Cordido, Fernando; Berrocal, Víctor Rodríguez; Pascual-Corrales, Eider; Guerrero-Pérez, Fernando; Vicente, Almudena; García-Centeno, Rogelio; González, Laura; García, María Dolores Ollero; Echarri, Ana Irigaray; Rodríguez, María Dolores Moure; Novo-Rodríguez, Cristina; Calatayud, María; Villar-Taibo, Rocío; Bernabéu, Ignacio; Alvarez-Escola, Cristina; Jimenéz, Carmen Tenorio; Abellán-Galiana, Pablo; Venegas, Eva; González-Molero, Inmaculada; Iglesias, Pedro; Blanco, Concepción; Lara, Fernando Vidal Ostos de; Novoa, María Paz de Miguel; Torres, Elena López Mezquita; Hanzu, Felicia; Lamas, Cristina; Rodríguez, Silvia Aznar; Aulinas, Anna; Recio, José María; Aviles-Pérez, María Dolores; Núñez, Miguel Antonio Sampedro; Camara, Rosa; Fano, Miguel Paja; Fajardo, Carmen; Cardoso, Luís; Marques, Pedro; Martínez-Sáez, Elena; Ruz-Caracuel, Ignacio; Marazuela, Mónica; Puig-Domingo, Manel
    Aim: To evaluate which factors are associated with a higher probability of failure to surgical and first-generation somatostatin receptor ligands (fgSRLs) treatment in patients with growth hormone and prolactin co-secreting pituitary adenomas (GH&PRL-PAs). Methods: Acromegaly patients with GH&PRL-PAs included in the ACRO-SPAIN study were enrolled. GH&PRL-PAs were defined as tumors with serum PRL levels above the upper limit of normal and positive immunostaining for GH and PRL, or with PRL levels ≥100 ng/mL when immunostaining data were not available. Results: A total of 126 acromegaly patients with GH&PRL-PAs who underwent transsphenoidal pituitary surgery were included, and 42.1% (n = 53) were biochemically cured at the immediate postoperative evaluation. Knosp grade >2 (odds ratio (OR) 3.48, 95% CI 1.28–9.38), higher serum GH (OR 1.01, 95% CI 1.01–1.08) and IGF-1 (OR 1.60, 95% CI 1.05–2.45) levels were associated with a lower probability of surgical cure. Sixty-eight patients received first-line medical therapy as follows: fgSRLs in monotherapy (n = 22), fgSRL plus cabergoline (n = 37), cabergoline in monotherapy (n = 7) and pegvisomant in monotherapy (n = 2). Among the cases treated with fgSRL in monotherapy, 18.2% (n = 4/22) were resistant. We identified as predictors of fgSRL resistance (in monotherapy and combined with cabergoline) a Knosp grade >2 (OR 8.75, P = 0.003), high GH levels at acromegaly diagnosis (OR 1.02, P = 0.031) and higher postoperative GH levels (OR 1.05, P = 0.006), but no predictors of response to fgSRL in monotherapy were identified. Conclusion: The clinical predictors of surgical failure and of fgSRL resistance in patients with GH&PRL-PAs are similar to those described in acromegaly without PRL, co-secretion.
    2025-07-15Research article Open access Show more