Efficacy and safety of somatostatin anologues and trans-sphenoidal surgery in the treatment of Acromegaly

Abstract

Among the treatment options for Acromegaly, trans-sphenoidal surgery is the first option in most cases. However, most patients have invasive tumors at diagnosis, with a low chance of surgical cure, so most end up getting the somatostatin analog (SA) as a complementary treatment. Previous studies comparing the trans-sphenoidal surgery versus the SA as a primary treatment for this neoplasia have shown controversial results. It has also been studied whether the SA given before surgery may improve the final surgical outcome, but there is no evidence in this regard. When comparing octreotide versus lanreotide, both seem to be effective in treating additional surgery. However, there aren't systematic reviews involving these topics, and the principal existing studies took into account the old criteria for Acromegaly cure (basal GH <2.5 ng / mL and normal IGF1). This study will evaluate the efficacy and safety of SAs and trans-sphenoidal surgery in the treatment of Acromegaly, comparing: (a) surgery versus surgery preceded by SA and (b) the SAS each other. In all these sub-items will be compared the results with the old criteria for cure versus the current (basal GH <1 ng / mL and normal IGF1). For this, there will be a systematic literature review according to the Cochrane methodology. When the data from more than one study are homogeneous and with similar clinical outcomes, they will be plotted in a meta-analysis. (AU)