Multidisciplinary management of acromegaly: A consensus
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Multidisciplinary management of acromegaly: A consensus Andrea Giustina 1 & Garni Barkhoudarian 2 & Albert Beckers 3 & Anat Ben-Shlomo 4 & Nienke Biermasz 5 & Beverly Biller 6 & Cesar Boguszewski 7 & Marek Bolanowski 8 & Jens Bollerslev 9 & Vivien Bonert 4 & Marcello D. Bronstein 10 & Michael Buchfelder 11 & Felipe Casanueva 12 & Philippe Chanson 13 & David Clemmons 14 & Maria Fleseriu 15 & Anna Maria Formenti 1 & Pamela Freda 16 & Monica Gadelha 17 & Eliza Geer 18 & Mark Gurnell 19 & Anthony P. Heaney 20 & Ken K. Y. Ho 21 & Adriana G. Ioachimescu 22 & Steven Lamberts 23 & Edward Laws 24 & Marco Losa 25 & Pietro Maffei 26 & Adam Mamelak 4 & Moises Mercado 27 & Mark Molitch 28 & Pietro Mortini 25 & Alberto M. Pereira 5 & Stephan Petersenn 29 & Kalmon Post 30 & Manuel Puig-Domingo 31 & Roberto Salvatori 32 & Susan L. Samson 33 & Ilan Shimon 34 & Christian Strasburger 35 & Brooke Swearingen 36 & Peter Trainer 37 & Mary L. Vance 38 & John Wass 39 & Margaret E. Wierman 40 & Kevin C. J. Yuen 41 & Maria Chiara Zatelli 42 & Shlomo Melmed 4 Accepted: 1 September 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract The 13th Acromegaly Consensus Conference was held in November 2019 in Fort Lauderdale, Florida, and comprised acromegaly experts including endocrinologists and neurosurgeons who considered optimal approaches for multidisciplinary acromegaly management. Focused discussions reviewed techniques, results, and side effects of surgery, radiotherapy, and medical therapy, and how advances in technology and novel techniques have changed the way these modalities are used alone or in combination. Effects of treatment on patient outcomes were considered, along with strategies for optimizing and personalizing therapeutic approaches. Expert consensus recommendations emphasize how best to implement available treatment options as part of a multidisciplinary approach at Pituitary Tumor Centers of Excellence. Keywords Acromegaly . Consensus . Multidisciplinary management . Medical therapy . Surgery . Radiotherapy . Pituitary tumor centers of excellence
1 Introduction Acromegaly is a chronic, progressive, and potentially lethal disease caused by a growth hormone (GH)-secreting pituitary adenoma and resultant excess in circulating levels of GH and insulin-like growth factor (IGF)-I [1]. Facial and acral changes due to soft tissue overgrowth as well as systemic complications affecting bone and joints [2] and the cardio-respiratory system [3], in association with metabolic and oncologic complications, contribute to an increased clinical burden, leading to decreased quality of life and diminished survival rates [4, 5]. Unfortunately, most patients already exhibit features of advanced disease at presentation due to a delay in diagnosis from first symptom onset by up to 8–10 years [6]. Treatment of acromegaly is targeted to normalizing biochemical
* Andrea Giustina [email protected] Extended author information available on the last page of the article
parameters as well as improving well being, contr
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