{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T11:14:49Z","timestamp":1793272489687,"version":"4.5.0"},"reference-count":76,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,5,1]]},"abstract":"<jats:p>This review aimed to highlight the history, diagnostic criteria, preoperative prognostic factors, surgical management, and multimodal adjuvant therapies recommended to provide a comprehensive and multifaceted understanding of and clinical approach to treating growth hormone\u2013secreting pituitary adenomas (GHPAs) in patients with acromegaly. The authors collated and reviewed published studies, many written by skull base neurosurgeons, endocrinologists, and radiation oncologists with expertise in pituitary adenoma management, to produce a practical and contemporary update pertaining to the optimal management of acromegaly for neurosurgeons. Acromegaly is a debilitating disease for which surgery can be curative in more than two-thirds of patients. Recent rates of hormonal remission by the authors\u2019 group and others following the resection of GHPAs are on the order of 70%\u201380%, and these increase to more than 85% with the addition of medical therapy in a minority of patients who do not achieve remission with surgery alone. Most tumors are accessible via a direct endoscopic endonasal transsphenoidal approach, which can be augmented with a variety of extended approaches to gain access to suprasellar, clival, and parasellar compartments as needed. Preoperative growth hormone levels, cavernous sinus invasion, and pituitary adenoma consistency are important factors in determining the extent of resection. In most patients with residual or recurrent disease, medical therapy (e.g., somatostatin analogs and dopamine agonists) can be used to help achieve hormonal remission. Repeat surgery can be safely performed in most cases if needed, whereas stereotactic radiosurgery is usually reserved for medically resistant tumors in surgically inaccessible compartments. The neurosurgeon has a primary and often definitive role in the management of acromegaly. The involvement of an integrated and multidisciplinary team consisting of experts from neurosurgery, otolaryngology, endocrinology, and radiation oncology optimizes the chances for a biochemical cure, even in large and aggressive GHPAs.<\/jats:p>","DOI":"10.3171\/2023.8.jns221975","type":"journal-article","created":{"date-parts":[[2023,11,11]],"date-time":"2023-11-11T01:29:12Z","timestamp":1699666152000},"page":"1285-1294","source":"Crossref","is-referenced-by-count":9,"title":["Management of growth hormone\u2013secreting pituitary adenomas causing acromegaly: a practical review of surgical and multimodal management strategies for neurosurgeons"],"prefix":"10.3171","volume":"140","author":[{"given":"Stephanie K.","family":"Cheok","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, University of Southern California Keck School of Medicine, Los Angeles; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John D.","family":"Carmichael","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Endocrinology, University of Southern California Keck School of Medicine, Los Angeles, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel","family":"Zada","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Southern California Keck School of Medicine, Los Angeles; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"1","key":"b1","series-title":"Neuroendocrinology","first-page":"7","article-title":"The history of acromegaly","volume":"103","author":"de Herder WW","year":"2016","unstructured":"de Herder WW. The history of acromegaly. Neuroendocrinology. 2016;103(1):7\u201317."},{"issue":"1","key":"b2","series-title":"Pituitary","first-page":"7","article-title":"A history of acromegaly","volume":"2","author":"Sheaves R","year":"1999","unstructured":"Sheaves R. A history of acromegaly. Pituitary. 1999;2(1):7\u201328."},{"key":"b3","article-title":"Growth Hormone Deficiency: Physiology and Clinical Management","author":"Cohen LE","year":"2016","unstructured":"Cohen LE. Growth Hormone Deficiency: Physiology and Clinical Management. Springer International Publishing; 2016."},{"key":"b4","series-title":"Clin Neurosurg","first-page":"185","article-title":"Transphenoidal microsurgery of the normal and pathological pituitary","volume":"16","author":"Hardy J","year":"1969","unstructured":"Hardy J. Transphenoidal microsurgery of the normal and pathological pituitary. Clin Neurosurg. 1969;16:185\u2013217."},{"key":"b5","series-title":"Clin Neurosurg","first-page":"374","article-title":"Medical and surgical management of functional pituitary tumors","volume":"28","author":"Weiss MH","year":"1981","unstructured":"Weiss MH. Medical and surgical management of functional pituitary tumors. Clin Neurosurg. 1981;28:374\u2013383."},{"issue":"1","key":"b6","series-title":"Rev Endocr Metab Disord","first-page":"67","article-title":"Surgery for acromegaly: evolution of the techniques and outcomes","volume":"9","author":"Laws ER","year":"2008","unstructured":"Laws ER. Surgery for acromegaly: evolution of the techniques and outcomes. Rev Endocr Metab Disord. 2008;9(1):67\u201370."},{"issue":"3","key":"b7","series-title":"Endocrinol Metab Clin North Am","first-page":"669","article-title":"Surgical management of acromegaly","volume":"21","author":"Fahlbusch R","year":"1992","unstructured":"Fahlbusch R, Honegger J, Buchfelder M. Surgical management of acromegaly. Endocrinol Metab Clin North Am. 1992;21(3):669\u2013692."},{"issue":"4","key":"b8","series-title":"Endocr Relat Cancer","first-page":"C5","article-title":"From pituitary adenoma to pituitary neuroendocrine tumor (PitNET): an International Pituitary Pathology Club proposal","volume":"24","author":"Asa SL","year":"2017","unstructured":"Asa SL, Casar-Borota O, Chanson P,  From pituitary adenoma to pituitary neuroendocrine tumor (PitNET): an International Pituitary Pathology Club proposal. Endocr Relat Cancer. 2017;24(4):C5\u2013C8."},{"issue":"24","key":"b9","series-title":"N Engl J Med","first-page":"2558","article-title":"Medical progress: acromegaly","volume":"355","author":"Melmed S","year":"2006","unstructured":"Melmed S. Medical progress: acromegaly. N Engl J Med. 2006;355(24):2558\u20132573."},{"issue":"11","key":"b10","series-title":"Endocr Pract","first-page":"1327","article-title":"Incidence and prevalence of acromegaly in the United States: a claims-based analysis","volume":"22","author":"Broder MS","year":"2016","unstructured":"Broder MS, Chang E, Cherepanov D, Neary MP, Ludlam WH. Incidence and prevalence of acromegaly in the United States: a claims-based analysis. Endocr Pract. 2016;22(11):1327\u20131335."},{"issue":"6","key":"b11","series-title":"J Clin Endocrinol Metab","first-page":"1955","article-title":"Acromegaly and McCune-Albright syndrome","volume":"99","author":"Salenave S","year":"2014","unstructured":"Salenave S, Boyce AM, Collins MT, Chanson P. Acromegaly and McCune-Albright syndrome. J Clin Endocrinol Metab. 2014;99(6):1955\u20131969."},{"issue":"6","key":"b12","series-title":"Endocr Relat Cancer","first-page":"469","article-title":"Mortality in acromegaly: a 20-year follow-up study","volume":"23","author":"Ritvonen E","year":"2016","unstructured":"Ritvonen E, L\u00f6yttyniemi E, Jaatinen P,  Mortality in acromegaly: a 20-year follow-up study. Endocr Relat Cancer. 2016;23(6):469\u2013480."},{"issue":"2","key":"b13","series-title":"J Clin Endocrinol Metab","first-page":"667","article-title":"Factors influencing mortality in acromegaly","volume":"89","author":"Holdaway IM","year":"2004","unstructured":"Holdaway IM, Rajasoorya RC, Gamble GD. Factors influencing mortality in acromegaly. J Clin Endocrinol Metab. 2004;89(2):667\u2013674."},{"issue":"9","key":"b14","series-title":"Nat Rev Endocrinol","first-page":"552","article-title":"A Consensus Statement on acromegaly therapeutic outcomes","volume":"14","author":"Melmed S","year":"2018","unstructured":"Melmed S, Bronstein MD, Chanson P,  A Consensus Statement on acromegaly therapeutic outcomes. Nat Rev Endocrinol. 2018;14(9):552\u2013561."},{"issue":"6","key":"b15","series-title":"Eur J Endocrinol","first-page":"523","article-title":"Prolonged diagnostic delay in acromegaly is associated with increased morbidity and mortality","volume":"182","author":"Esposito D","year":"2020","unstructured":"Esposito D, Ragnarsson O, Johannsson G, Olsson DS. Prolonged diagnostic delay in acromegaly is associated with increased morbidity and mortality. Eur J Endocrinol. 2020;182(6):523\u2013531."},{"issue":"1","key":"b16","series-title":"Clin Endocrinol (Oxf)","first-page":"65","article-title":"Variation in GH and IGF-I assays limits the applicability of international consensus criteria to local practice","volume":"67","author":"Pokrajac A","year":"2007","unstructured":"Pokrajac A, Wark G, Ellis AR, Wear J, Wieringa GE, Trainer PJ. Variation in GH and IGF-I assays limits the applicability of international consensus criteria to local practice. Clin Endocrinol (Oxf). 2007;67(1):65\u201370."},{"issue":"2","key":"b17","series-title":"Eur Endocrinol","first-page":"57","article-title":"Updates in diagnosis and treatment of acromegaly","volume":"14","author":"Zahr R","year":"2018","unstructured":"Zahr R, Fleseriu M. Updates in diagnosis and treatment of acromegaly. Eur Endocrinol. 2018;14(2):57\u201361."},{"issue":"10","key":"b18","series-title":"Nat Rev Endocrinol","first-page":"605","article-title":"The changing face of acromegaly\u2014advances in diagnosis and treatment","volume":"8","author":"Ribeiro-Oliveira A Jr","year":"2012","unstructured":"Ribeiro-Oliveira A Jr, Barkan A. The changing face of acromegaly\u2014advances in diagnosis and treatment. Nat Rev Endocrinol. 2012;8(10):605\u2013611."},{"issue":"12","key":"b19","series-title":"Acta Neurochir (Wien)","first-page":"2245","article-title":"Predictive value of diffusion-weighted MRI for tumor consistency and resection rate of nonfunctional pituitary macroadenomas","volume":"156","author":"Alimohamadi M","year":"2014","unstructured":"Alimohamadi M, Sanjari R, Mortazavi A,  Predictive value of diffusion-weighted MRI for tumor consistency and resection rate of nonfunctional pituitary macroadenomas. Acta Neurochir (Wien). 2014;156(12):2245\u20132252."},{"issue":"5","key":"b20","series-title":"J Neurosurg","first-page":"1356","article-title":"Predicting pituitary adenoma consistency with preoperative magnetic resonance elastography","volume":"136","author":"Cohen-Cohen S","year":"2021","unstructured":"Cohen-Cohen S, Helal A, Yin Z,  Predicting pituitary adenoma consistency with preoperative magnetic resonance elastography. J Neurosurg. 2021;136(5):1356\u20131363."},{"issue":"5","key":"b21","series-title":"J Neurol Surg B Skull Base","first-page":"340","article-title":"Prediction of consistency of pituitary adenomas by magnetic resonance imaging","volume":"76","author":"Smith KA","year":"2015","unstructured":"Smith KA, Leever JD, Chamoun RB. Prediction of consistency of pituitary adenomas by magnetic resonance imaging. J Neurol Surg B Skull Base. 2015;76(5):340\u2013343."},{"issue":"4","key":"b22","series-title":"Neurosurgery","first-page":"610","article-title":"Pituitary adenomas with invasion of the cavernous sinus space: a magnetic resonance imaging classification compared with surgical findings","volume":"33","author":"Knosp E","year":"1993","unstructured":"Knosp E, Steiner E, Kitz K, Matula C. Pituitary adenomas with invasion of the cavernous sinus space: a magnetic resonance imaging classification compared with surgical findings. Neurosurgery. 1993;33(4):610\u2013618."},{"issue":"4","key":"b23","series-title":"J Neurosurg","first-page":"803","article-title":"Invasion of the cavernous sinus space in pituitary adenomas: endoscopic verification and its correlation with an MRI-based classification","volume":"122","author":"Micko AS","year":"2015","unstructured":"Micko AS, W\u00f6hrer A, Wolfsberger S, Knosp E. Invasion of the cavernous sinus space in pituitary adenomas: endoscopic verification and its correlation with an MRI-based classification. J Neurosurg. 2015;122(4):803\u2013811."},{"issue":"4","key":"b24","series-title":"Neurosurg Focus","first-page":"E8","article-title":"Transsphenoidal surgery in patients with acromegaly: operative strategies for overcoming technically challenging anatomical variations","volume":"29","author":"Zada G","year":"2010","unstructured":"Zada G, Cavallo LM, Esposito F,  Transsphenoidal surgery in patients with acromegaly: operative strategies for overcoming technically challenging anatomical variations. Neurosurg Focus. 2010;29(4):E8."},{"issue":"3","key":"b25","series-title":"Pituitary","first-page":"480","article-title":"Growth hormone secreting pituitary adenomas show distinct extrasellar extension patterns compared to nonfunctional pituitary adenomas","volume":"25","author":"Pangal DJ","year":"2022","unstructured":"Pangal DJ, Wishart D, Shiroishi MS, Ruzevick J, Carmichael JD, Zada G. Growth hormone secreting pituitary adenomas show distinct extrasellar extension patterns compared to nonfunctional pituitary adenomas. Pituitary. 2022;25(3):480\u2013485."},{"issue":"4","key":"b26","series-title":"Neurosurg Focus","first-page":"E4","article-title":"Patterns of extrasellar extension in growth hormone-secreting and nonfunctional pituitary macroadenomas","volume":"29","author":"Zada G","year":"2010","unstructured":"Zada G, Lin N, Laws ER Jr. Patterns of extrasellar extension in growth hormone-secreting and nonfunctional pituitary macroadenomas. Neurosurg Focus. 2010;29(4):E4."},{"issue":"11","key":"b27","series-title":"Acta Neurochir (Wien)","first-page":"2109","article-title":"Surgical treatment of acromegaly according to the 2010 remission criteria: systematic review and meta-analysis","volume":"158","author":"Starnoni D","year":"2016","unstructured":"Starnoni D, Daniel RT, Marino L, Pitteloud N, Levivier M, Messerer M. Surgical treatment of acromegaly according to the 2010 remission criteria: systematic review and meta-analysis. Acta Neurochir (Wien). 2016;158(11):2109\u20132121."},{"key":"b28","series-title":"Int J Endocrinol","first-page":"386401","article-title":"Surgery and radiosurgery for acromegaly: a review of indications, operative techniques, outcomes, and complications","volume":"2012","author":"Marquez Y","year":"2012","unstructured":"Marquez Y, Tuchman A, Zada G. Surgery and radiosurgery for acromegaly: a review of indications, operative techniques, outcomes, and complications. Int J Endocrinol. 2012;2012:386401."},{"issue":"6","key":"b29","series-title":"Neurosurg Focus","first-page":"E10","article-title":"Impact of tumor characteristics and pre- and postoperative hormone levels on hormonal remission following endoscopic transsphenoidal surgery in patients with acromegaly","volume":"48","author":"Cardinal T","year":"2020","unstructured":"Cardinal T, Rutkowski MJ, Micko A,  Impact of tumor characteristics and pre- and postoperative hormone levels on hormonal remission following endoscopic transsphenoidal surgery in patients with acromegaly. Neurosurg Focus. 2020;48(6):E10."},{"issue":"8","key":"b30","series-title":"J Clin Endocrinol Metab","first-page":"3190","article-title":"Endoscopic vs microsurgical transsphenoidal surgery for acromegaly: outcomes in a concurrent series of patients using modern criteria for remission","volume":"98","author":"Starke RM","year":"2013","unstructured":"Starke RM, Raper DM, Payne SC, Vance ML, Oldfield EH, Jane JA Jr. Endoscopic vs microsurgical transsphenoidal surgery for acromegaly: outcomes in a concurrent series of patients using modern criteria for remission. J Clin Endocrinol Metab. 2013;98(8):3190\u20133198."},{"issue":"3","key":"b31","series-title":"J Neurosurg","first-page":"816","article-title":"Endoscopic versus nonendoscopic surgery for resection of pituitary adenomas: a national database study","volume":"134","author":"Goshtasbi K","year":"2020","unstructured":"Goshtasbi K, Lehrich BM, Abouzari M,  Endoscopic versus nonendoscopic surgery for resection of pituitary adenomas: a national database study. J Neurosurg. 2020;134(3):816\u2013824."},{"issue":"6","key":"b32","series-title":"J Neurosurg","first-page":"1800","article-title":"Development and clinical validation of a grading system for pituitary adenoma consistency","volume":"134","author":"Rutkowski MJ","year":"2020","unstructured":"Rutkowski MJ, Chang KE, Cardinal T,  Development and clinical validation of a grading system for pituitary adenoma consistency. J Neurosurg. 2020;134(6):1800\u20131807."},{"issue":"3","key":"b33","series-title":"J Neurosurg","first-page":"776","article-title":"Treatment strategies for giant pituitary adenomas in the era of endoscopic transsphenoidal surgery: a multicenter series","volume":"136","author":"Micko A","year":"2021","unstructured":"Micko A, Agam MS, Brunswick A,  Treatment strategies for giant pituitary adenomas in the era of endoscopic transsphenoidal surgery: a multicenter series. J Neurosurg. 2021;136(3):776\u2013785."},{"issue":"1","key":"b34","series-title":"J Neurosurg","first-page":"91","article-title":"Endoscopic endonasal transcavernous posterior clinoidectomy with interdural pituitary transposition","volume":"121","author":"Fernandez-Miranda JC","year":"2014","unstructured":"Fernandez-Miranda JC, Gardner PA, Rastelli MM Jr,  Endoscopic endonasal transcavernous posterior clinoidectomy with interdural pituitary transposition. J Neurosurg. 2014;121(1):91\u201399."},{"issue":"2","key":"b35","series-title":"J Neurosurg","first-page":"430","article-title":"Cavernous sinus compartments from the endoscopic endonasal approach: anatomical considerations and surgical relevance to adenoma surgery","volume":"129","author":"Fernandez-Miranda JC","year":"2018","unstructured":"Fernandez-Miranda JC, Zwagerman NT, Abhinav K,  Cavernous sinus compartments from the endoscopic endonasal approach: anatomical considerations and surgical relevance to adenoma surgery. J Neurosurg. 2018;129(2):430\u2013441."},{"issue":"3","key":"b36","series-title":"J Neurosurg","first-page":"505","article-title":"Aggressive transsphenoidal resection of tumors invading the cavernous sinus in patients with acromegaly: predictive factors, strategies, and outcomes","volume":"121","author":"Nishioka H","year":"2014","unstructured":"Nishioka H, Fukuhara N, Horiguchi K, Yamada S. Aggressive transsphenoidal resection of tumors invading the cavernous sinus in patients with acromegaly: predictive factors, strategies, and outcomes. J Neurosurg. 2014;121(3):505\u2013510."},{"issue":"4 suppl 2","key":"b37","series-title":"Oper Neurosurg (Hagerstown)","first-page":"295","article-title":"Graded repair of cranial base defects and cerebrospinal fluid leaks in transsphenoidal surgery","volume":"60","author":"Esposito F","year":"2007","unstructured":"Esposito F, Dusick JR, Fatemi N, Kelly DF. Graded repair of cranial base defects and cerebrospinal fluid leaks in transsphenoidal surgery. Oper Neurosurg (Hagerstown). 2007;60(4 suppl 2):295\u2013304."},{"issue":"3","key":"b38","series-title":"Pituitary","first-page":"288","article-title":"Complications of endoscopic surgery of the pituitary adenomas: analysis of 570 patients and review of the literature","volume":"15","author":"Berker M","year":"2012","unstructured":"Berker M, Hazer DB, Y\u00fccel T,  Complications of endoscopic surgery of the pituitary adenomas: analysis of 570 patients and review of the literature. Pituitary. 2012;15(3):288\u2013300."},{"key":"b39","series-title":"World Neurosurg","first-page":"e536","article-title":"Safety and effectiveness of the direct endoscopic endonasal approach for primary sellar pathology: a contemporary case series of more than 400 patients","volume":"148","author":"Cardinal T","year":"2021","unstructured":"Cardinal T, Brunswick A, Strickland BA,  Safety and effectiveness of the direct endoscopic endonasal approach for primary sellar pathology: a contemporary case series of more than 400 patients. World Neurosurg. 2021;148:e536\u2013e546."},{"issue":"11","key":"b40","series-title":"J Clin Med","first-page":"1962","article-title":"The clinicopathological spectrum of acromegaly","volume":"8","author":"Akirov A","year":"2019","unstructured":"Akirov A, Asa SL, Amer L, Shimon I, Ezzat S. The clinicopathological spectrum of acromegaly. J Clin Med. 2019;8(11):1962."},{"issue":"2","key":"b41","series-title":"Endocrine","first-page":"310","article-title":"Mammosomatotroph and mixed somatotroph-lactotroph adenoma in acromegaly: a retrospective study with long-term follow-up","volume":"66","author":"Lv L","year":"2019","unstructured":"Lv L, Jiang Y, Yin S,  Mammosomatotroph and mixed somatotroph-lactotroph adenoma in acromegaly: a retrospective study with long-term follow-up. Endocrine. 2019;66(2):310\u2013318."},{"issue":"1","key":"b42","series-title":"Endocrine","first-page":"231","article-title":"Growth hormone tumor histological subtypes predict response to surgical and medical therapy","volume":"49","author":"Kiseljak-Vassiliades K","year":"2015","unstructured":"Kiseljak-Vassiliades K, Carlson NE, Borges MT,  Growth hormone tumor histological subtypes predict response to surgical and medical therapy. Endocrine. 2015;49(1):231\u2013241."},{"issue":"3","key":"b43","series-title":"Endocr Pathol","first-page":"228","article-title":"Overview of the 2017 WHO Classification of Pituitary Tumors","volume":"28","author":"Mete O","year":"2017","unstructured":"Mete O, Lopes MB. Overview of the 2017 WHO Classification of Pituitary Tumors. Endocr Pathol. 2017;28(3):228\u2013243."},{"issue":"2","key":"b44","series-title":"J Neurosurg","first-page":"195","article-title":"The long-term significance of microscopic dural invasion in 354 patients with pituitary adenomas treated with transsphenoidal surgery","volume":"96","author":"Meij BP","year":"2002","unstructured":"Meij BP, Lopes MB, Ellegala DB, Alden TD, Laws ER Jr. The long-term significance of microscopic dural invasion in 354 patients with pituitary adenomas treated with transsphenoidal surgery. J Neurosurg. 2002;96(2):195\u2013208."},{"issue":"3","key":"b45","series-title":"Eur J Endocrinol","first-page":"379","article-title":"The outcome of surgery in 668 patients with acromegaly using current criteria of biochemical \u2018cure\u2019","volume":"152","author":"Nomikos P","year":"2005","unstructured":"Nomikos P, Buchfelder M, Fahlbusch R. The outcome of surgery in 668 patients with acromegaly using current criteria of biochemical \u2018cure\u2019. Eur J Endocrinol. 2005;152(3):379\u2013387."},{"issue":"4","key":"b46","series-title":"J Neurosurg","first-page":"719","article-title":"Assessment of long-term remission of acromegaly following surgery","volume":"98","author":"Krieger MD","year":"2003","unstructured":"Krieger MD, Couldwell WT, Weiss MH. Assessment of long-term remission of acromegaly following surgery. J Neurosurg. 2003;98(4):719\u2013724."},{"issue":"7","key":"b47","series-title":"J Clin Endocrinol Metab","first-page":"3141","article-title":"A consensus on criteria for cure of acromegaly","volume":"95","author":"Giustina A","year":"2010","unstructured":"Giustina A, Chanson P, Bronstein MD,  A consensus on criteria for cure of acromegaly. J Clin Endocrinol Metab. 2010;95(7):3141\u20133148."},{"issue":"6","key":"b48","series-title":"J Neurosurg","first-page":"1467","article-title":"Treatment of acromegaly by endoscopic transsphenoidal surgery: surgical experience in 214 cases and cure rates according to current consensus criteria","volume":"119","author":"Hazer DB","year":"2013","unstructured":"Hazer DB, I\u015f\u0131k S, Berker D,  Treatment of acromegaly by endoscopic transsphenoidal surgery: surgical experience in 214 cases and cure rates according to current consensus criteria. J Neurosurg. 2013;119(6):1467\u20131477."},{"issue":"3","key":"b49","series-title":"Endocrine","first-page":"415","article-title":"Predictors of surgical outcome and early criteria of remission in acromegaly","volume":"60","author":"Antunes X","year":"2018","unstructured":"Antunes X, Ventura N, Camilo GB,  Predictors of surgical outcome and early criteria of remission in acromegaly. Endocrine. 2018;60(3):415\u2013422."},{"issue":"2","key":"b50","series-title":"Endocrine","first-page":"501","article-title":"Predictors of surgical outcome and early criteria of remission in acromegaly-some controversial issues","volume":"62","author":"Wang Z","year":"2018","unstructured":"Wang Z, Xing B. Predictors of surgical outcome and early criteria of remission in acromegaly-some controversial issues. Endocrine. 2018;62(2):501\u2013502."},{"issue":"2","key":"b51","series-title":"J Neurooncol","first-page":"313","article-title":"Predictors of postoperative biochemical remission in acromegaly","volume":"151","author":"Yao S","year":"2021","unstructured":"Yao S, Chen WL, Tavakol S,  Predictors of postoperative biochemical remission in acromegaly. J Neurooncol. 2021;151(2):313\u2013324."},{"key":"b52","series-title":"Front Endocrinol (Lausanne)","first-page":"743052","article-title":"Postoperative GH and degree of reduction in IGF-1 predicts postoperative hormonal remission in acromegaly","volume":"12","author":"Cardinal T","year":"2021","unstructured":"Cardinal T, Collet C, Wedemeyer M,  Postoperative GH and degree of reduction in IGF-1 predicts postoperative hormonal remission in acromegaly. Front Endocrinol (Lausanne). 2021;12:743052."},{"issue":"9","key":"b53","series-title":"J Clin Endocrinol Metab","first-page":"2732","article-title":"Endoscopic transsphenoidal surgery for acromegaly: remission using modern criteria, complications, and predictors of outcome","volume":"96","author":"Jane JA Jr","year":"2011","unstructured":"Jane JA Jr, Starke RM, Elzoghby MA,  Endoscopic transsphenoidal surgery for acromegaly: remission using modern criteria, complications, and predictors of outcome. J Clin Endocrinol Metab. 2011;96(9):2732\u20132740."},{"issue":"11","key":"b54","series-title":"J Endocrinol Invest","first-page":"2427","article-title":"First but not second postoperative day growth hormone assessments as early predictive tests for long-term acromegaly persistence","volume":"44","author":"Cambria V","year":"2021","unstructured":"Cambria V, Beccuti G, Prencipe N,  First but not second postoperative day growth hormone assessments as early predictive tests for long-term acromegaly persistence. J Endocrinol Invest. 2021;44(11):2427\u20132433."},{"issue":"2","key":"b55","series-title":"Neurol India","first-page":"252","article-title":"Can immediate postoperative random growth hormone levels predict long-term cure in patients with acromegaly?","volume":"64","author":"Dutta P","year":"2016","unstructured":"Dutta P, Korbonits M, Sachdeva N,  Can immediate postoperative random growth hormone levels predict long-term cure in patients with acromegaly? Neurol India. 2016;64(2):252\u2013258."},{"issue":"1","key":"b56","series-title":"Pituitary","first-page":"71","article-title":"Clinical factors involved in the recurrence of pituitary adenomas after surgical remission: a structured review and meta-analysis","volume":"15","author":"Roelfsema F","year":"2012","unstructured":"Roelfsema F, Biermasz NR, Pereira AM. Clinical factors involved in the recurrence of pituitary adenomas after surgical remission: a structured review and meta-analysis. Pituitary. 2012;15(1):71\u201383."},{"issue":"4","key":"b57","series-title":"Neurosurgery","first-page":"949","article-title":"Repeat transsphenoidal surgery for the treatment of remaining or recurring pituitary tumors in acromegaly","volume":"67","author":"Yamada S","year":"2010","unstructured":"Yamada S, Fukuhara N, Oyama K, Takeshita A, Takeuchi Y. Repeat transsphenoidal surgery for the treatment of remaining or recurring pituitary tumors in acromegaly. Neurosurgery. 2010;67(4):949\u2013956."},{"issue":"3","key":"b58","series-title":"J Clin Endocrinol Metab","first-page":"e532","article-title":"Biochemical control in acromegaly with multimodality therapies: outcomes from a pituitary center and changes over time","volume":"105","author":"Ghajar A","year":"2020","unstructured":"Ghajar A, Jones PS, Guarda FJ,  Biochemical control in acromegaly with multimodality therapies: outcomes from a pituitary center and changes over time. J Clin Endocrinol Metab. 2020;105(3):e532\u2013e543."},{"issue":"4","key":"b59","series-title":"Pituitary","first-page":"459","article-title":"Repeat endoscopic transsphenoidal surgery for acromegaly: remission and complications","volume":"16","author":"Wilson TJ","year":"2013","unstructured":"Wilson TJ, McKean EL, Barkan AL, Chandler WF, Sullivan SE. Repeat endoscopic transsphenoidal surgery for acromegaly: remission and complications. Pituitary. 2013;16(4):459\u2013464."},{"issue":"2","key":"b60","series-title":"J Neurosurg","first-page":"239","article-title":"Surgical outcome after repeated transsphenoidal surgery in acromegaly","volume":"85","author":"Long H","year":"1996","unstructured":"Long H, Beauregard H, Somma M, Comtois R, Serri O, Hardy J. Surgical outcome after repeated transsphenoidal surgery in acromegaly. J Neurosurg. 1996;85(2):239\u2013247."},{"issue":"5","key":"b61","series-title":"J Clin Endocrinol Metab","first-page":"1327","article-title":"Place of cabergoline in acromegaly: a meta-analysis","volume":"96","author":"Sandret L","year":"2011","unstructured":"Sandret L, Maison P, Chanson P. Place of cabergoline in acromegaly: a meta-analysis. J Clin Endocrinol Metab. 2011;96(5):1327\u20131335."},{"issue":"1","key":"b62","series-title":"Pituitary","first-page":"18","article-title":"Rapid and sustained reduction of serum growth hormone and insulin-like growth factor-1 in patients with acromegaly receiving lanreotide Autogel therapy: a randomized, placebo-controlled, multicenter study with a 52 week open extension","volume":"13","author":"Melmed S","year":"2010","unstructured":"Melmed S, Cook D, Schopohl J, Goth MI, Lam KS, Marek J. Rapid and sustained reduction of serum growth hormone and insulin-like growth factor-1 in patients with acromegaly receiving lanreotide Autogel therapy: a randomized, placebo-controlled, multicenter study with a 52 week open extension. Pituitary. 2010;13(1):18\u201328."},{"issue":"3","key":"b63","series-title":"Pituitary","first-page":"235","article-title":"Interpreting biochemical control response rates with first-generation somatostatin analogues in acromegaly","volume":"19","author":"Colao A","year":"2016","unstructured":"Colao A, Auriemma RS, Pivonello R, Kasuki L, Gadelha MR. Interpreting biochemical control response rates with first-generation somatostatin analogues in acromegaly. Pituitary. 2016;19(3):235\u2013247."},{"issue":"5","key":"b64","series-title":"J Clin Endocrinol Metab","first-page":"1825","article-title":"Acromegaly clinical trial methodology impact on reported biochemical efficacy rates of somatostatin receptor ligand treatments: a meta-analysis","volume":"99","author":"Carmichael JD","year":"2014","unstructured":"Carmichael JD, Bonert VS, Nu\u00f1o M, Ly D, Melmed S. Acromegaly clinical trial methodology impact on reported biochemical efficacy rates of somatostatin receptor ligand treatments: a meta-analysis. J Clin Endocrinol Metab. 2014;99(5):1825\u20131833."},{"issue":"4","key":"b65","series-title":"Eur J Endocrinol","first-page":"525","article-title":"More than a decade of real-world experience of pegvisomant for acromegaly: ACROSTUDY","volume":"185","author":"Fleseriu M","year":"2021","unstructured":"Fleseriu M, F\u00fchrer-Sakel D, van der Lely AJ,  More than a decade of real-world experience of pegvisomant for acromegaly: ACROSTUDY. Eur J Endocrinol. 2021;185(4):525\u2013538."},{"issue":"3","key":"b66","series-title":"Neurosurgery","first-page":"717","article-title":"Stereotactic radiosurgery for acromegaly: an international multicenter retrospective cohort study","volume":"84","author":"Ding D","year":"2019","unstructured":"Ding D, Mehta GU, Patibandla MR,  Stereotactic radiosurgery for acromegaly: an international multicenter retrospective cohort study. Neurosurgery. 2019;84(3):717\u2013725."},{"issue":"1","key":"b67","series-title":"Radiat Oncol","first-page":"135","article-title":"Target delineation and optimal radiosurgical dose for pituitary tumors","volume":"11","author":"Minniti G","year":"2016","unstructured":"Minniti G, Osti MF, Niyazi M. Target delineation and optimal radiosurgical dose for pituitary tumors. Radiat Oncol. 2016;11(1):135."},{"key":"b68","series-title":"Radiat Oncol","first-page":"167","article-title":"Radiation techniques for acromegaly","volume":"6","author":"Minniti G","year":"2011","unstructured":"Minniti G, Scaringi C, Enrici RM. Radiation techniques for acromegaly. Radiat Oncol. 2011;6:167."},{"issue":"2","key":"b69","series-title":"J Neurosurg","first-page":"303","article-title":"Gamma Knife surgery for pituitary adenomas: factors related to radiological and endocrine outcomes","volume":"114","author":"Sheehan JP","year":"2011","unstructured":"Sheehan JP, Pouratian N, Steiner L, Laws ER, Vance ML. Gamma Knife surgery for pituitary adenomas: factors related to radiological and endocrine outcomes. J Neurosurg. 2011;114(2):303\u2013309."},{"issue":"3","key":"b70","series-title":"J Clin Endocrinol Metab","first-page":"1287","article-title":"Octreotide may act as a radioprotective agent in acromegaly","volume":"85","author":"Landolt AM","year":"2000","unstructured":"Landolt AM, Haller D, Lomax N,  Octreotide may act as a radioprotective agent in acromegaly. J Clin Endocrinol Metab. 2000;85(3):1287\u20131289."},{"issue":"8","key":"b71","series-title":"J Clin Endocrinol Metab","first-page":"4483","article-title":"Outcome of gamma knife radiosurgery in 82 patients with acromegaly: correlation with initial hypersecretion","volume":"90","author":"Castinetti F","year":"2005","unstructured":"Castinetti F, Taieb D, Kuhn JM,  Outcome of gamma knife radiosurgery in 82 patients with acromegaly: correlation with initial hypersecretion. J Clin Endocrinol Metab. 2005;90(8):4483\u20134488."},{"issue":"3","key":"b72","series-title":"Eur J Endocrinol","first-page":"265","article-title":"Treatment of aggressive pituitary tumours and carcinomas: results of a European Society of Endocrinology (ESE) survey 2016","volume":"178","author":"McCormack A","year":"2018","unstructured":"McCormack A, Dekkers OM, Petersenn S,  Treatment of aggressive pituitary tumours and carcinomas: results of a European Society of Endocrinology (ESE) survey 2016. Eur J Endocrinol. 2018;178(3):265\u2013276."},{"key":"b73","series-title":"EBioMedicine","first-page":"537","article-title":"Unmasking a new prognostic marker and therapeutic target from the GDNF-RET\/PIT1\/p14ARF\/p53 pathway in acromegaly","volume":"43","author":"Chenlo M","year":"2019","unstructured":"Chenlo M, Rodriguez-Gomez IA, Serramito R,  Unmasking a new prognostic marker and therapeutic target from the GDNF-RET\/PIT1\/p14ARF\/p53 pathway in acromegaly. EBioMedicine. 2019;43:537\u2013552."},{"key":"b74","series-title":"Front Endocrinol (Lausanne)","first-page":"608422","article-title":"The progress of immunotherapy in refractory pituitary adenomas and pituitary carcinomas","volume":"11","author":"Dai C","year":"2020","unstructured":"Dai C, Liang S, Sun B, Kang J. The progress of immunotherapy in refractory pituitary adenomas and pituitary carcinomas. Front Endocrinol (Lausanne). 2020;11:608422."},{"key":"b75","series-title":"Rev Neurol","first-page":"225","article-title":"Hyperfonction de la glande pituitaire et acrom\u00e9galie; gigantisme et acrom\u00e9galie","volume":"3","author":"Massolongo R","year":"1895","unstructured":"Massolongo R. Hyperfonction de la glande pituitaire et acrom\u00e9galie; gigantisme et acrom\u00e9galie. Rev Neurol. 1895;3225."},{"issue":"4","key":"b76","series-title":"Cancer","first-page":"698","article-title":"Growth hormone from monkey and human pituitary glands","volume":"10","author":"Li CH","year":"1957","unstructured":"Li CH. Growth hormone from monkey and human pituitary glands. Cancer. 1957;10(4):698\u2013703."}],"container-title":["Journal of Neurosurgery"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/140\/5\/article-p1285.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/140\/5\/article-p1285.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg\/140\/5\/article-p1285.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,25]],"date-time":"2024-05-25T10:23:43Z","timestamp":1716632623000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg\/140\/5\/article-p1285.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,1]]},"references-count":76,"journal-issue":{"issue":"5"},"URL":"https:\/\/doi.org\/10.3171\/2023.8.jns221975","relation":{},"ISSN":["0022-3085","1933-0693"],"issn-type":[{"value":"0022-3085","type":"print"},{"value":"1933-0693","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,1]]}}}