Influence of GH substitution therapy in deficient adults on the recurrence rate of hormonally inactive pituitary adenomas: a case?control study

[~MaryO~]

http://www.eje.org/cgi/content/abstract/157/2/149

 

DOI: 10.1530/EJE-07-0164

European Journal of Endocrinology, Vol 157, Issue 2, 149-156

Copyright ? 2007 by Society of the European Journal of Endocrinology

 

CLINICAL STUDY

Influence of GH substitution therapy in deficient adults on the recurrence rate of hormonally inactive pituitary adenomas: a case?control study

 

Michael Buchfelder, Peter Herbert Kann1, Christian W?ster2, Ulrich Tuschy3, Bernhard Saller4, Georg Brabant4, Andrea Kleindienst, Panagiotis Nomikos the German KIMS Board

 

Department of Neurosurgery, University of Erlangen-Nuremberg, Schwabachanlage 6, D-91054 Erlangen, Germany, 1 Division of Endocrinology and Diabetology, University of Marburg, Marburg, D-35032 Germany, 2 Department of Medicine, University of Heidelberg, Heidelberg, D-61920 Germany, 3 Department of Medicine, Helios Hospital, D-99089 Erfurt, Germany, 4 Department of Medicine, University of Essen, D-45122 Essen, Germany and 5 Department of Medicine, Hannover Medical School, D-30623 Hannover, Germany

 

(Correspondence should be addressed to M Buchfelder; Email: buchfelder@nch.imed.uni-erlangen.de)

 

Objective: Several studies documented metabolic and psychological benefits of GH substitution in deficient adults, most of them suffering from benign pituitary adenomas. Since GH substitution is considered to promote tumour regrowth, adequate treatment is performed with some reservation. Therefore, we aimed to elucidate the effect of GH replacement therapy on tumour recurrence following surgery.

 

Methods: In patients with hormonally inactive pituitary adenomas undergoing tumour surgery, a retrospective case?control study was performed. Pre- and postoperative magnetic resonance (MR) images of GH-treated and untreated patients were matched for best fit by two independent observers. The treated patients were retrieved from the surveillance programme of the German KIMS database and the untreated from the database of the Department of Neurosurgery, University of Erlangen. A total of 55 matched pairs were followed for at least 5 years. Tumour recurrence and progression rates were determined according to the postoperative MR.

 

Results: There were 16 tumour progressions in the treatment group and 12 in the control group. Statistical analysis revealed no significant increase in either recurrence (P = 0.317) or progression (P = 0.617) within the follow-up period of 5 years when GH was adequately replaced.

 

Conclusions: This study provides further observational data of substitution therapy in GH-deficient adults with pituitary adenomas. Comparing long-term surgical results, we found no evidence that GH substitution should be withheld in deficient patients. Even residual tumour does not constitute a contraindication to GH replacement. However, since pituitary tumours are slow growing, an observational period of 5 years may not have been long enough to verify any absolute influence on recurrence potential.

[denney]

Mary,

 

This sounds like good news. I have not been in the situation described but I can imagine it would be frustrating to go through the pit surgery and then find out treatment options were limited because of concerns that GH therapy would be detrimental.

 

Any chance that any of this research would filter over into allowing GH replacement in individuals with a history of cancer?

 

Thanks

den

[~MaryO~]

Any chance that any of this research would filter over into allowing GH replacement in individuals with a history of cancer?

 

I don't know but that info would be useful for me! I always wondered, through, if the GH caused my cancer to grow