{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T09:16:48Z","timestamp":1780046208693,"version":"3.53.1"},"reference-count":42,"publisher":"The Endocrine Society","issue":"6","license":[{"start":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T00:00:00Z","timestamp":1778630400000},"content-version":"vor","delay-in-days":7,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,5,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Context<\/jats:title>\n                    <jats:p>Acromegaly, characterized by excess growth hormone (GH) and insulin-like growth factor-1 production, is typically caused by a pituitary somatotroph adenoma. Disease activity and treatment responses vary widely according to its structural-functional classification comprising clinical, pathologic, morphologic, and biochemical features, particularly adenoma size and invasiveness on pituitary MRI and GH-granulation pattern.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the association between clinicopathologic acromegaly subtypes and long-term survival.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This multicenter, bidirectional cohort study assessed all-cause mortality in adults with somatotroph adenomas classified into 3 different subtypes. Patients with Type 1 acromegaly have noninvasive or invasive microadenomas that are densely granulated; Type 2 noninvasive macroadenomas are densely or sparsely granulated; and Type 3 invasive macroadenomas are sparsely granulated. The primary outcome was all-cause mortality, analyzed by subtype.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The cohort comprised 550 patients, including 50.5% women, with a mean age at diagnosis of 42.3 years (standard deviation 13.7) and a median follow-up after diagnosis of 11.3 years (interquartile range 4.1-19.8). 172 patients (31.2%) had Type 1, 143 (26%) Type 2, and 235 (42.7%) Type 3. Overall mortality was 12.9%. Rates varied significantly across subtypes (P = .003): Type 1 had the lowest mortality at 7.0%, followed by Type 2 at 12.0%, and Type 3 at 17.9%. On multivariate Cox regression, Type 2 (hazard ratio [HR] = 2.76, 95% CI: 1.86-7.81, P = .009), and Type 3 (HR = 4.69, 95% CI: 1.65-13.3, P = .004) exhibited significantly higher mortality risk vs Type 1, independent of treatment modalities and presence of comorbidities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Applying a structural-functional acromegaly classification enables distinction of significant differences in long-term survival outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1210\/jendso\/bvag111","type":"journal-article","created":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T11:25:48Z","timestamp":1778585148000},"source":"Crossref","is-referenced-by-count":0,"title":["Impact of acromegaly subtypes on survival: results from a large multicenter cohort"],"prefix":"10.1210","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6330-670X","authenticated-orcid":false,"given":"Daniel","family":"Cuevas-Ramos","sequence":"first","affiliation":[{"name":"Neuroendocrinology Clinic, Department of Endocrinology and Metabolism, Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubiran , Mexico City, 14080 ,","place":["Mexico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Artak","family":"Labadzhyan","sequence":"additional","affiliation":[{"name":"Pituitary Center, Cedars-Sinai Medical Center , Los Angeles, CA 90048 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Gomez","sequence":"additional","affiliation":[{"name":"Pituitary Center, Cedars-Sinai Medical Center , Los Angeles, CA 90048 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"Fox","sequence":"additional","affiliation":[{"name":"Pituitary Center, Cedars-Sinai Medical Center , Los Angeles, CA 90048 ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Froylan David","family":"Mart\u00ednez-S\u00e1nchez","sequence":"additional","affiliation":[{"name":"Neuroendocrinology Clinic, Department of Endocrinology and Metabolism, Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubiran , Mexico City, 14080 ,","place":["Mexico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Rocha-Haro","sequence":"additional","affiliation":[{"name":"Neuroendocrinology Clinic, Department of Endocrinology and Metabolism, Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubiran , Mexico City, 14080 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