The effect of preoperative short-term octreotide treatment to surgery in thyrotropin-secreting pituitary adenomas: a retrospective cohort study.
Biochemical remission rate
GTR
Octreotide
Thyrotropin-secreting pituitary adenomas
Journal
BMC endocrine disorders
ISSN: 1472-6823
Titre abrégé: BMC Endocr Disord
Pays: England
ID NLM: 101088676
Informations de publication
Date de publication:
17 Aug 2023
17 Aug 2023
Historique:
received:
09
11
2022
accepted:
30
06
2023
medline:
18
8
2023
pubmed:
17
8
2023
entrez:
16
8
2023
Statut:
epublish
Résumé
To prevent thyroid storm and ensure surgical safety, it is imperative to regulate excessive thyroid hormone levels in patients with thyrotropin-secreting pituitary adenomas (TSHoma) prior to surgery. Somatostatin analogues (SSAs), such as octreotide, have showed efficacy in shrinking tumors, which may facilitate surgical resection. This retrospective study aimed to investigate the effect of shortterm preoperative octreotide treatment on the surgical outcome of TSHoma. A total of 65 TSHoma patients from January 2010 to July 2019 were included in the study. Of these,41 patients received short-term preoperative octreotide (Sandostatin, intermittent subcutaneous injection) treatment and all patients subsequently underwent surgery. The following data were recorded: clinical manifestations, laboratory examinations, sellar region MRI, postoperative pathological and electron microscopy data, intraoperative situation, and follow-up (> 3 months) regarding hormone levels and tumor recurrence. There was no significant difference in the consistency and blood supply of the tumor between patients who received short-term preoperative octreotide treatment and those who did not. Additionally, preoperative short-term octreotide treatment (median of 10 days with a range of 6-18 days) did not significantly improve the rates of gross total resection (GTR) or biochemical remission. Moreover, electron microscopy revealed subcellular level impairments and cell apoptotic in the octreotide treated TSHoma specimens. Preoperative octreotide treatment for the purpose of reducing excessive thyroid hormones may not enhance surgical outcomes, and the duration of octreotide treatment needs to be extended to fully benefit from the tumor-shrinking effects of SSAs.
Sections du résumé
BACKGROUND
BACKGROUND
To prevent thyroid storm and ensure surgical safety, it is imperative to regulate excessive thyroid hormone levels in patients with thyrotropin-secreting pituitary adenomas (TSHoma) prior to surgery. Somatostatin analogues (SSAs), such as octreotide, have showed efficacy in shrinking tumors, which may facilitate surgical resection. This retrospective study aimed to investigate the effect of shortterm preoperative octreotide treatment on the surgical outcome of TSHoma.
METHODS
METHODS
A total of 65 TSHoma patients from January 2010 to July 2019 were included in the study. Of these,41 patients received short-term preoperative octreotide (Sandostatin, intermittent subcutaneous injection) treatment and all patients subsequently underwent surgery. The following data were recorded: clinical manifestations, laboratory examinations, sellar region MRI, postoperative pathological and electron microscopy data, intraoperative situation, and follow-up (> 3 months) regarding hormone levels and tumor recurrence.
RESULTS
RESULTS
There was no significant difference in the consistency and blood supply of the tumor between patients who received short-term preoperative octreotide treatment and those who did not. Additionally, preoperative short-term octreotide treatment (median of 10 days with a range of 6-18 days) did not significantly improve the rates of gross total resection (GTR) or biochemical remission. Moreover, electron microscopy revealed subcellular level impairments and cell apoptotic in the octreotide treated TSHoma specimens.
CONCLUSION
CONCLUSIONS
Preoperative octreotide treatment for the purpose of reducing excessive thyroid hormones may not enhance surgical outcomes, and the duration of octreotide treatment needs to be extended to fully benefit from the tumor-shrinking effects of SSAs.
Identifiants
pubmed: 37587420
doi: 10.1186/s12902-023-01398-z
pii: 10.1186/s12902-023-01398-z
pmc: PMC10433543
doi:
Substances chimiques
Octreotide
RWM8CCW8GP
Somatostatin
51110-01-1
Thyrotropin
9002-71-5
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
176Informations de copyright
© 2023. BioMed Central Ltd., part of Springer Nature.
Références
Clin Endocrinol (Oxf). 2012 Mar;76(3):407-14
pubmed: 21848909
Endocr J. 2021 Jul 28;68(7):791-805
pubmed: 33692246
Am Fam Physician. 2013 Sep 1;88(5):319-27
pubmed: 24010395
Endocrinol Diabetes Metab Case Rep. 2015;2015:150007
pubmed: 26113979
Eur Thyroid J. 2013 Jun;2(2):76-82
pubmed: 24783044
Chin Med J (Engl). 2017 Apr 20;130(8):936-942
pubmed: 28397723
J Clin Endocrinol Metab. 2001 Jun;86(6):2849-53
pubmed: 11397898
Steroids. 2020 Feb;154:108535
pubmed: 31704334
Pituitary. 2011 Jun;14(2):141-7
pubmed: 21086053
Best Pract Res Clin Endocrinol Metab. 2009 Oct;23(5):597-606
pubmed: 19945025
Minerva Endocrinol. 2008 Dec;33(4):329-40
pubmed: 18923369
J Endocrinol Invest. 2019 Dec;42(12):1401-1406
pubmed: 31175617
Pituitary. 2019 Feb;22(1):79-88
pubmed: 30390277
Clin Endocrinol (Oxf). 2014 Mar;80(3):395-402
pubmed: 23848527
Med Sci Monit. 2017 Apr 23;23:1947-1955
pubmed: 28434012
Endocrine. 2016 Jun;52(3):427-40
pubmed: 26792794
Eur J Endocrinol. 2006 Aug;155(2):371-9
pubmed: 16868153
Endocr J. 2015;62(1):21-7
pubmed: 25273395
Endocr Pathol. 1995 Summer;6(2):125-134
pubmed: 12114648
Endocr Pract. 2008 Sep;14(6):732-7
pubmed: 18996794
Ann Intern Med. 1993 Aug 1;119(3):236-40
pubmed: 8323093
Clin Neurol Neurosurg. 2018 Apr;167:24-30
pubmed: 29433055
J Neurosurg. 2000 Aug;93(2):194-200
pubmed: 10930003
BMC Endocr Disord. 2017 Sep 6;17(1):55
pubmed: 28874187
J Clin Endocrinol Metab. 2013 Nov;98(11):E1730-9
pubmed: 24092823