Clinical, hormonal, and treatment outcomes in 247 patients with acromegaly: a single tertiary center experience

Authors

• ÜMRAN GÜLFollow
• BEKİR UÇANFollow
• HAYRİ BOSTANFollow
• HAKAN DÜĞERFollow
• HAYRİ KERTMENFollow
• CANER ÜNLÜERFollow
• HALİL DURANTAŞFollow
• OĞULCAN BOZFollow
• CEREN KARAÇALIK ÜNVERFollow
• BURAK MENEKŞEFollow
• SEMA HEPŞENFollow
• İLKNUR ÖZTÜRK ÜNSALFollow
• MUSTAFA ÖZBEKFollow
• ERMAN ÇAKALFollow
• MUHAMMED KIZILGÜLFollow

Abstract

Background/aim: This study aimed to evaluate the demographic, clinical, and hormonal characteristics; comorbidities; surgical pathology; treatment modalities; and long-term clinical outcomes of patients diagnosed with and managed for acromegaly at our tertiary referral center over a 15-year period.

Materials and methods: Between 2010 and 2024, 247 patients with acromegaly were evaluated. Diagnosis and biochemical remission were determined according to the 2024 Acromegaly Consensus Criteria.

Results: The median follow-up duration was 8 years (IQR: 3–14). At the time of diagnosis, the most frequent pituitary hormone deficiency was secondary adrenal insufficiency, present in 17.8% of patients. The most common comorbidities were hypertension (HT, 42.1%) and diabetes mellitus (DM, 30.8%). At the time of diagnosis, macroadenomas were present in 153 of 193 patients (79.3%), and, according to the Knosp classification, 28.6% of tumors were grade 4. A total of 218 patients underwent surgical intervention; 86 (39.4%) achieved postoperative cure without the need for adjuvant medical therapy or radiotherapy. Postoperatively, one or more anterior pituitary hormone deficiencies were found in 34 patients (22.8%), with central hypothyroidism being the most common (52.9%). Patients who achieved biochemical remission were significantly older (p = 0.003), had a higher prevalence of HT and DM (both p < 0.05), and were more likely to exhibit positive growth hormone (GH) immunostaining (p = 0.017). In contrast, those who did not achieve remission were more likely to have higher Knosp grades (3–4) (p = 0.002).

Conclusions: In this study, a favorable prognosis was associated with older age at diagnosis, lower baseline GH levels, positive GH immunostaining, smaller tumor size, and lower Knosp grade, underscoring the prognostic value of both biochemical and anatomical parameters. Further studies are warranted to refine prognostic markers and establish standardized treatment algorithms to improve long-term outcomes in acromegaly.

Author ORCID Identifier

ÜMRAN GÜL: 0000-0001-7958-486X

BEKİR UÇAN: 0000-0002-0810-5224

HAYRİ BOSTAN: 0000-0002-4957-9856

HAKAN DÜĞER: 0000-0001-5478-3192

HAYRİ KERTMEN: 0000-0002-7113-9830

CANER ÜNLÜER: 0000-0002-2052-7278

HALİL DURANTAŞ: 0009-0005-6249-1532

OĞULCAN BOZ: 0000-0003-2858-4207

CEREN KARAÇALIK ÜNVER: 0000-0002-1219-5541

BURAK MENEKŞE: 0000-0002-1010-110X

SEMA HEPŞEN: 0000-0002-8375-7409

İLKNUR ÖZTÜRK ÜNSAL: 0000-0003-3999-6426

MUSTAFA ÖZBEK: 0000-0003-1125-3823

ERMAN ÇAKAL: 0000-0003-4455-7276

MUHAMMED KIZILGÜL: 0000-0002-8468-9196

DOI

10.55730/1300-0144.6205

Keywords

Acromegaly, GH, IGF-1, long-term follow-up, treatment

First Page

718

Last Page

729

Publisher

The Scientific and Technological Research Council of Türkiye (TÜBİTAK)

Creative Commons License

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

Recommended Citation

GÜL, Ü, UÇAN, B, BOSTAN, H, DÜĞER, H, KERTMEN, H, ÜNLÜER, C, DURANTAŞ, H, BOZ, O, KARAÇALIK ÜNVER, C, MENEKŞE, B, HEPŞEN, S, ÖZTÜRK ÜNSAL, İ, ÖZBEK, M, ÇAKAL, E, & KIZILGÜL, M (2026). Clinical, hormonal, and treatment outcomes in 247 patients with acromegaly: a single tertiary center experience. Turkish Journal of Medical Sciences 56 (3): 718-729. https://doi.org/10.55730/1300-0144.6205