References

endoserg

Эндокринная хирургия

Endocrine Surgery

2306-35132310-3965

Типография «Печатных дел Мастер»

10.14341/serg9642

endoserg-9642

Research Article

Обзоры литературы

Review of literature

Влияние предоперационной терапии аналогами соматостатина на исход хирургического лечения СТГ-продуцирующих макроаденом гипофиза: критический анализ

Preoperative treatment of growth hormone (GH) producing macroadenomas with somatostatin receptor ligands (SRLs) to improve surgical outcome: a critical analysis

https://orcid.org/0000-0002-5453-0248

Баркан

Ариэль

Barkan

Ariel

д.м.н., профессор медицины и нейрохирургии, cо-директор Центра нейроэндокринологии и заболеваний гипофиза

MD, Professor of Medicine and Neurosurgery, Co-Director, Pituitary and Neuroendocrine Center, Division of Metabolism, Endocrinology and Diabetes, Department of Internal Medicine, Department of Neurosurgery

abarkan@umich.edu

<p>Мичиганский университет</p>Соединённые Штаты Америки<p>University of Michigan</p>United States

2018

18072018

121718

2018

Баркан А.

Barkan A.

Данная работа распространяется под лицензией Creative Commons Attribution 4.0.

This work is licensed under a Creative Commons Attribution 4.0 License.

https://www.surg-endojournals.ru/jour/article/view/9642

Тридцать лет назад была выдвинута гипотеза, согласно которой уменьшение размера макроаденом гипофиза, продуцирующих соматотропный гормон (СТГ), под действием аналогов соматостатина (АС) может улучшить исход хирургического лечения. С тех пор множество ретроспективных нерандомизированных исследований, а также четыре современных проспективных рандомизированных исследования были проведены для проверки истинности этой гипотезы. Oни критически разобраны в этой статье.

За исключением единичных ретроспективных исследований, преобладающее большинство работ не подтверждают эту гипотезу. Также, хотя все проспективные исследования указывают на улучшение хирургического исхода через 3 мес после операции при проведении предоперационной подготовки АС, различия между пациентами, получавшими лечение до операции, и нелечеными пациентами из группы контроля исчезают через 6–12 мес.

Таким образом, предоперационная терапия макросоматотропином АС с целью достижения полного удаления опухоли не оправдывает ожиданий и не может быть рекомендована.

Thirty years ago, a hypothesis stating that preoperative shrinkage of growth hormone (GH) producing macroadenomas with somatostatin receptor ligands (SRLs) may improve surgical outcome was put forward. Since then, multiple retrospective, non-randomized studies as well as four contemporary prospective, randomized studies have been performed to evaluate the validity of that hypothesis and are critically reviewed in this manuscript.

With the exception of an occasional retrospective study the great preponderance of evidence could not confirm this hypothesis. Similarly, while all prospective studies suggested better surgical outcome for SRL-pretreated tumors 3 months post surgery, the differences in outcomes between pretreated and untreated control patients disappeared after 6–12 months.

Thus, preoperative treatment of macrosomatotropinomas with SRLs should not be relied upon as a means to achieve complete tumor removal and cannot be recommended.

акромегалияСТГ-продуцирующая аденома гипофизатрансназальная аденомэктомияаналоги соматостатина

acromegalygrowth hormone-secreting pituitary adenomaoctreotidetreatment outcome

References1

Surya S, Horowitz JF, Goldenberg N, et al. The pattern of growth hormone delivery to peripheral tissues determines insulin-like growth factor-1 and lipolytic responses in obese subjects. J Clin Endocrinol Metab. 2009;94(8):2828-2834. doi: 10.1210/jc.2009-0638.

Faje AT, Barkan AL. Basal, but not pulsatile, growth hormone secretion determines the ambient circulating levels of insulin-like growth factor-I. J Clin Endocrinol Metab. 2010;95(5): 2486-2491. doi: 10.1210/jc.2009-2634.

Dimaraki EV, Jaffe CA, DeMott-Friberg R, et al. Acromegaly with apparently normal GH secretion: implications for diagnosis and follow-up. J Clin Endocrinol Metab. 2002; 87(8):3537-3542. doi: 10.1210/jcem.87.8.8658.

Duarte FH, Jallad RS, Bronstein MD. Estrogens and selective estrogen receptor modulators in acromegaly. Endocrine. 2016;54(2):306-314. doi: 10.1007/s12020-016-1118-z.

Shimon I, Cohen ZR, Ram Z, Hadani M. Transsphenoidal surgery for acromegaly: endocrinological follow-up of 98 patients. Neurosurgery. 2001;48(6):1239-1243. doi: 10.1097/0006123-200106000-00008.

Nomikos P, Buchfelder M, Fahlbusch R. The outcome of surgery in 668 patients with acromegaly using current criteria of biochemical 'cure'. Eur J Endocrinol. 2005;152(3):379-387. doi: 10.1530/eje.1.01863.

Casanueva FF, Barkan AL, Buchfelder M, et al. Criteria for the definition of Pituitary Tumor Centers of Excellence (PTCOE): A Pituitary Society Statement. Pituitary. 2017;20(5):489-498. doi: 10.1007/s11102-017-0838-2.

Gittoes NJL. Outcome of surgery for acromegaly – the experience of a dedicated pituitary surgeon. QJM. 1999;92(12): 741-745. doi: 10.1093/qjmed/92.12.741.

Ciric I, Ragin A, Baumgartner C, Pierce D. Complications of transsphenoidal surgery: results of a national survey, review of the literature, and personal experience. Neurosurgery. 1997;40(2):225-237. doi: 10.1097/0006123-199702000-00001.

Barkan AL, Lloyd RV, Chandler WF, et al. Preoperative treatment of acromegaly with long-acting somatostatin analog SMS 201-995: shrinkage of invasive pituitary macroadenomas and improved surgical remission rate. J Clin Endocrinol Metab. 1988;67(5):1040-1048. doi: 10.1210/jcem-67-5-1040.

Giustina A, Mazziotti G, Torri V, et al. Meta-analysis on the effects of octreotide on tumor mass in acromegaly. PLoS One. 2012;7(5):e36411. doi: 10.1371/journal.pone.0036411.

Caron PJ, Bevan JS, Petersenn S, et al. Tumor shrinkage with lanreotide Autogel 120 mg as primary therapy in acromegaly: results of a prospective multicenter clinical trial. J Clin Endocrinol Metab. 2014;99(4):1282-1290. doi: 10.1210/jc.2013-3318.

Annamalai AK, Webb A, Kandasamy N, et al. A comprehensive study of clinical, biochemical, radiological, vascular, cardiac, and sleep parameters in an unselected cohort of patients with acromegaly undergoing presurgical somatostatin receptor ligand therapy. J Clin Endocrinol Metab. 2013;98(3):1040-1050. doi: 10.1210/jc.2012-3072.

Schmid HA, Schoeffter P. Functional activity of the multiligand analog SOM230 at human recombinant somatostatin receptor subtypes supports its usefulness in neuroendocrine tumors. Neuroendocrinology. 2004;80 Suppl 1:47-50. doi: 10.1159/000080741.

Schmid HA. Pasireotide (SOM230): development, mechanism of action and potential applications. Mol Cell Endocrinol. 2008;286(1-2):69-74. doi: 10.1016/j.mce.2007.09.006.

Colao A, Bronstein MD, Freda P, et al. Pasireotide versus octreotide in acromegaly: a head-to-head superiority study. J Clin Endocrinol Metab. 2014;99(3):791-799. doi: 10.1210/jc.2013-2480.

Bevan JS, Atkin SL, Atkinson AB, et al. Primary medical therapy for acromegaly: an open, prospective, multicenter study of the effects of subcutaneous and intramuscular slow-release octreotide on growth hormone, insulin-like growth factor-I, and tumor size. J Clin Endocrinol Metab.2002; 87(10):4554-4563. doi: 10.1210/jc.2001-012012.

Barkan AL, Kelch RP, Hopwood NJ, Beitins IZ. Treatment of acromegaly with the long-acting somatostatin analog SMS 201-995. J Clin Endocrinol Metab. 1988;66(1):16-23. doi: 10.1210/jcem-66-1-16.

Potorac I, Petrossians P, Daly AF, et al. T2-weighted MRI signal predicts hormone and tumor responses to somatostatin analogs in acromegaly. Endocr Relat Cancer. 2016;23(11): 871-881. doi: 10.1530/ERC-16-0356.

Puig-Domingo M, Resmini E, Gomez-Anson B, et al. Magnetic resonance imaging as a predictor of response to somatostatin analogs in acromegaly after surgical failure. J Clin Endocrinol Metab. 2010;95(11):4973-4978. doi: 10.1210/jc.2010-0573.

Heck A, Emblem KE, Casar-Borota O, et al. Quantitative analyses of T2-weighted MRI as a potential marker for response to somatostatin analogs in newly diagnosed acromegaly. Endocrine. 2016;52(2):333-343. doi: 10.1007/s12020-015-0766-8.

Fougner SL, Casar-Borota O, Heck A, et al. Adenoma granulation pattern correlates with clinical variables and effect of somatostatin analogue treatment in a large series of patients with acromegaly. Clin Endocrinol (Oxf). 2012;76(1):96-102. doi: 10.1111/j.1365-2265.2011.04163.x.

Brzana J, Yedinak CG, Gultekin SH, et al. Growth hormone granulation pattern and somatostatin receptor subtype 2A correlate with postoperative somatostatin receptor ligand response in acromegaly: a large single center experience. Pituitary. 2013;16(4):490-498. doi: 10.1007/s11102-012-0445-1.

Ezzat S, Horvath E, Harris AG, Kovacs K. Morphological effects of octreotide on growth hormone-producing pituitary adenomas. J Clin Endocrinol Metab. 1994;79(1):113-118. doi: 10.1210/jcem.79.1.8027215.

Lv L, Hu Y, Zhou P, et al. Presurgical treatment with somatostatin analogues in growth hormone-secreting pituitary adenomas: A long-term single-center experience. Clin Neurol Neurosurg. 2018;167:24-30. doi: 10.1016/j.clineuro.2018.02.006.

Kristof RA, Stoffel-Wagner B, Klingmüller D, Schramm J. Does octreotide treatment improve the surgical results of macro-adenomas in acromegaly? A randomized study. Acta Neurochir (Wien). 1999;141(4):399-405. doi: 10.1007/s007010050316.

Biermasz NR, van Dulken H, Roelfsema F. Direct postoperative and follow-up results of transsphenoidal surgery in 19 acromegalic patients pretreated with octreotide compared to those in untreated matched controls. J Clin Endocrinol Metab. 1999;84(10):3551-3555. doi: 10.1210/jcem.84.10.6027.

Losa M, Mortini P, Urbaz L, et al. Presurgical treatment with somatostatin analogs in patients with acromegaly: effects on the remission and complication rates. J Neurosurg. 2006;104(6):899-906. doi: 10.3171/jns.2006.104.6.899.

Abe T, Ludecke D. Effects of preoperative octreotide treatment on different subtypes of 90 GH-secreting pituitary adenomas and outcome in one surgical centre. Eur J Endocrinol. 2001;145(2):137-145. doi: 10.1530/eje.0.1450137.

Stevenaert A, Beckers A. Presurgical octreotide: Treatment in acromegaly. Metabolism. 1996;45:72-74. doi: 10.1016/s0026-0495(96)90088-8.

Plockinger U, Quabbe HJ. Presurgical octreotide treatment in acromegaly: no improvement of final growth hormone (GH) concentration and pituitary function. A long-term case-control study. Acta Neurochir (Wien). 2005;147(5):485-493. doi: 10.1007/s00701-005-0511-9.

Colao A, Ferone D, Cappabianca P, et al. Effect of octreotide pretreatment on surgical outcome in acromegaly. J Clin Endocrinol Metab. 1997;82(10):3308-3314. doi: 10.1210/jcem.82.10.4283.

Petersenn S, Buchfelder M, Reincke M, et al. Results of surgical and somatostatin analog therapies and their combination in acromegaly: a retrospective analysis of the German Acromegaly Register. Eur J Endocrinol. 2008; 159(5):525-532. doi: 10.1530/EJE-08-0498.

Giustina A, Barkan A, Casanueva FF, et al. Criteria for cure of acromegaly: a consensus statement. J Clin Endocrinol Metab. 2000;85(2):526-529. doi: 10.1210/jcem.85.2.6363.

Mao ZG, Zhu YH, Tang HL, et al. Preoperative lanreotide treatment in acromegalic patients with macroadenomas increases short-term postoperative cure rates: a prospective, randomised trial. Eur J Endocrinol. 2010;162(4): 661-666. doi: 10.1530/EJE-09-0908.

Li ZQ, Quan Z, Tian HL, Cheng M. Preoperative lanreotide treatment improves outcome in patients with acromegaly resulting from invasive pituitary macroadenoma. J Int Med Res. 2012;40(2):517-524. doi: 10.1177/147323001204000213.

Shen M, Shou X, Wang Y, et al. Effect of presurgical long-acting octreotide treatment in acromegaly patients with invasive pituitary macroadenomas: a prospective randomized study. Endocr J. 2010;57(12):1035-1044. doi: 10.1507/endocrj.K10E-203.

Carlsen SM, Lund-Johansen M, Schreiner T, et al. Preoperative octreotide treatment in newly diagnosed acromegalic patients with macroadenomas increases cure short-term postoperative rates: a prospective, randomized trial. J Clin Endocrinol Metab. 2008;93(8):2984-2990. doi: 10.1210/jc.2008-0315.

Fougner SL, Bollerslev J, Svartberg J, et al. Preoperative octreotide treatment of acromegaly: long-term results of a randomised controlled trial. Eur J Endocrinol. 2014;171(2):229-235. doi: 10.1530/EJE-14-0249.

Dogansen SC, Yalin GY, Tanrikulu S, et al. Clinicopathological significance of baseline T2-weighted signal intensity in functional pituitary adenomas. Pituitary. 2018. doi: 10.1007/s11102-018-0877-3.

Pita-Gutierrez F, Pertega-Diaz S, Pita-Fernandez S, et al. Place of preoperative treatment of acromegaly with somatostatin analog on surgical outcome: a systematic review and meta-analysis. PLoS One. 2013;8(4):e61523. doi: 10.1371/journal.pone.0061523.

Jacob JJ, Bevan JS. Should all patients with acromegaly receive somatostatin analogue therapy before surgery and, if so, for how long? Clin Endocrinol (Oxf). 2014;81(6):812-817. doi: 10.1111/cen.12553.

Bolanowski M, Bar-Andziak E, Kos-Kudla B, et al. Consensus statement of the Polish Society for Endocrinology: presurgical somatostatin analogs therapy in acromegaly. Neuro Endocrinol Lett. 2008;29(1):59-62.

Ferone D, Gatto F, Minuto F. Pre-surgical treatment with somatostatin analogues in patients with acromegaly: the case for. J Endocrinol Invest. 2012;35(6):613-615. doi: 10.1007/BF03345797.

Losa M, Bollerslev J. Pros and cons in endocrine practice: pre-surgical treatment with somatostatin analogues in acromegaly. Endocrine. 2016;52(3):451-457. doi: 10.1007/s12020-015-0853-x.

Fleseriu M, Hoffman AR, Katznelson L, et al. American Association of Clinical Endocrinologists and American College of Endocrinology Disease State Clinical Review: Management of acromegaly patients: What is the role of pre-operative medical therapy? Endocr Pract. 2015;21(6):668-673. doi: 10.4158/EP14575.DSCR.

The authors declare that there are no conflicts of interest present.