Endoscopic surgery for acromegaly: results from a large French-Italian study (25 years of experience)
Introduction
Acromegaly is a rare condition caused by excessive growth hormone secretion, usually due to a benign pituitary tumor (adenoma).
The standard treatment is endonasal endoscopic surgery, which allows removal of the tumor through the nose using a camera.
A large international study
Two expert neurosurgical teams, in France and Italy, analyzed 822 patients operated between 1998 and 2022.
This is one of the largest cohorts ever reported in acromegaly.
Main results
- Overall remission rate: 63%
- According to tumor type:
- Microadenomas (small, enclosed tumors): 88% remission
- Macroadenomas without major extension: 70%
- Invasive tumors (with cavernous sinus invasion): 2%
- Surgical complications were rare:
- Cerebrospinal fluid leak: 1%
- Meningitis: 0.6%
- Other complications: ≤1%
- New hormonal deficits after surgery: about 3% of patients
- Hormonal recurrence after initial remission: only 4% of patients, on average 3 years after surgery
Conclusion
This long-term study shows that:
- Endoscopic pituitary surgery is safe and effective when performed in reference centers.
- Cure rates are highest for small tumors.
- Once hormone levels are normalized, long-lasting remission can be expected in most patients.
