The results of transsphenoidal surgery as initial therapy for @entity10759 in 57 acromegalic @entity1 were analyzed retrospectively. @entity1 with prior surgery or radiation therapy were excluded from the study. Three different criteria were used to define remission: @entity413 -suppressed (nadir) GH less than 1.0 microg/liter, a normal sex- and age-adjusted @entity442 level, and postoperative random GH levels of 2.5 microg/liter or less. Additionally, we analyzed the neuropathological data, including immunohistochemistry and ultrastructural categorization, and the surgical complications. The short-term remission rate (6-wk postoperative follow-up visit), as determined by a random GH measurement of 2.5 microg/liter or less, was 48.8%; the remission rate, as determined by nadir GH, was 51.4%. For 57 @entity1 followed for 12 months or more after surgery (mean, 37.7 months), surgical remission was achieved in 70.2%, 66.7%, and 61.1%, respectively, for @entity1 assessed by normal @entity442 , random GH, and nadir GH. One @entity1 (1.1%) developed recurrence of active @entity2012 81 months after initially successful surgical therapy. Extrasellar growth of the @entity5 (P = 0.04) and dural invasion by the @entity652 (P = 0.008) were significant univariate predictors of a poor outcome. @entity5 size was significantly greater in @entity1 with persistent or recurrent @entity2012 (P = 0.02). @entity1 with @entity5 of the ultrastructural categories of mixed GH/PRL cell and mammosomatotroph @entity652 had the lowest remission rates (50% and 42.9%, respectively). There were no perioperative @entity204 , and there was no serious morbidity. The permanent complication rate was 3.3% (1 permanent @entity6684 and 2 nasal septal perforations). Surgical management of @entity2012 currently provides prompt, effective, and satisfactory initial treatment for the majority of @entity1 . Using stringent criteria for remission, primary transsphenoidal surgery for @entity10759 is effective and often definitive therapy for @entity2012 . These results provide a benchmark for the contemporary results of surgical management as assessed by modern outcome criteria.

Surgical management of XXXX : an outcome study using modern remission criteria.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'patient'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumor', 'Tumor', 'tumors'] @entity10759 :: ('MESH:D049912', 'Disease') :: ['GH-secreting pituitary adenomas'] @entity6684 :: ('MESH:C564703', 'Disease') :: ['DI'] @entity442 :: ('3479', 'Gene') :: ['IGF-I'] @entity2012 :: ('MESH:D000172', 'Disease') :: ['acromegaly'] @entity652 :: ('MESH:D000236', 'Disease') :: ['adenomas', 'adenoma'] @entity204 :: ('MESH:D003643', 'Disease') :: ['deaths'] @entity413 :: ('MESH:D005947', 'Chemical') :: ['glucose']
@entity10759 :: (MESH:D049912,Disease) :: ['GH-secreting pituitary adenomas']
