{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T19:30:11Z","timestamp":1774294211216,"version":"3.50.1"},"reference-count":31,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,4,14]],"date-time":"2022-04-14T00:00:00Z","timestamp":1649894400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:p>Acromegaly is a systemic disease that requires multidisciplinary treatment to achieve the best clinical outcome. This study aimed to evaluate the outcomes of the endoscopic transsphenoidal approach (TSA) as the primary treatment for somatotroph adenomas and further investigate patients who had suboptimal surgical results. This retrospective study included 83 patients with somatotroph adenomas treated by TSA at our institution from 1999 to 2010. Biochemical remission was defined as hGH &amp;lt;1 and &amp;lt;2.5 ng\/ml. Factors associated with failure of TSA and strategy of secondary treatments for refractory and recurrent disease were analyzed. The mean age of patients was 41.1 \u00b1 11.3 years, and the mean follow-up time was 54.2 \u00b1 44.3 months. Approximately 44.5% of patients had residual tumors after TSA. Larger tumor size, higher GH level before the operation, and the existence of residual tumors were associated with TSA failure. Forty-one patients had an inadequate response to TSA or a recurrent lesion, and of these patients, 37 had residual tumor after TSA. Octreotide results in good outcomes in the treatment of DGSA patients, and SRS\/EXRT generates good results in treating patients who receive second treatments when remission cannot be reached 6 months after TSA operation.<\/jats:p>","DOI":"10.3389\/fendo.2022.756855","type":"journal-article","created":{"date-parts":[[2022,4,14]],"date-time":"2022-04-14T13:26:46Z","timestamp":1649942806000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":12,"title":["Surgical Outcome and Evaluation of Strategies in the Management of Growth Hormone-Secreting Pituitary Adenomas After Initial Transsphenoidal Pituitary Adenectomy Failure"],"prefix":"10.3389","volume":"13","author":[{"given":"Jiun-Lin","family":"Yan","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mao-Yu","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yao-Liang","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chi-Cheng","family":"Chuang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peng-Wei","family":"Hsu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kuo-Chen","family":"Wei","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chen-Nen","family":"Chang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,4,14]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/B978-0-12-416021-7.00001-8","article-title":"Pituitary Gland Development and Disease: From Stem Cell to Hormone Production","volume":"106","author":"Davis","year":"2013","journal-title":"Curr Top Dev Biol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"30","DOI":"10.17925\/EE.2019.15.1.30","article-title":"Functioning Pituitary Adenomas - Current Treatment Options and Emerging Medical Therapies","volume":"15","author":"Varlamov","year":"2019","journal-title":"Eur Endocrinol"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1093\/neuonc\/now130","article-title":"Management of Hormone-Secreting Pituitary Adenomas","volume":"19","author":"Mehta","year":"2017","journal-title":"Neuro Oncol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1007\/s11102-017-0790-1","article-title":"Acromegaly, a Pituitary Special Issue","volume":"20","author":"Fleseriu","year":"2017","journal-title":"Pituitary"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.19699","article-title":"Diagnosis and Treatment of Pituitary Adenomas: A Review","volume":"317","author":"Molitch","year":"2017","journal-title":"JAMA"},{"key":"B6","doi-asserted-by":"publisher","first-page":"E2","DOI":"10.3171\/2010.7.FOCUS10169","article-title":"Growth Hormone-Secreting Adenomas: Pathology and Cell Biology","volume":"29","author":"Lopes","year":"2010","journal-title":"Neurosurg Focus"},{"key":"B7","volume-title":"Gigantism and Acromegaly. 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