M Arosio, V Sciannameo, A Contarino, P Berchialla, S Puglisi, A C Pesatori, E Ferrante, M Filopanti, R Pivonello, F Dassie, V Rochira, S Cannavò, E De Menis, F Pigliaru, S Grottoli, V Cambria, M Faustini-Fustini, M Montini, A Peri, F Ceccato, E Puxeddu, G Borretta, M Bondanelli, D Ferone, A Colao, M Terzolo, G Reimondo
{"title":"肢端肥大症的疾病控制并不能长期预防超额死亡率:意大利全国性调查的结果。","authors":"M Arosio, V Sciannameo, A Contarino, P Berchialla, S Puglisi, A C Pesatori, E Ferrante, M Filopanti, R Pivonello, F Dassie, V Rochira, S Cannavò, E De Menis, F Pigliaru, S Grottoli, V Cambria, M Faustini-Fustini, M Montini, A Peri, F Ceccato, E Puxeddu, G Borretta, M Bondanelli, D Ferone, A Colao, M Terzolo, G Reimondo","doi":"10.1007/s40618-023-02257-3","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to assess the long-term outcome of patients with acromegaly.</p><p><strong>Design: </strong>This is a multicenter, retrospective, observational study which extends the mean observation period of a previously reported cohort of Italian patients with acromegaly to 15 years of follow-up.</p><p><strong>Methods: </strong>Only patients from the centers that provided information on the life status of at least 95% of their original cohorts were included. Life status information was collected either from clinical records or from the municipal registry offices. Standardized mortality ratios (SMRs) were computed comparing data with those of the general Italian population.</p><p><strong>Results: </strong>A total of 811 patients were included. There were 153 deaths, with 90 expected and an SMR of 1.7 (95% CI 1.4-2.0, p < 0.001). Death occurred after a median of 15 (women) or 16 (men) years from the diagnosis, without gender differences. Mortality remained elevated in the patients with control of disease (SMR 1.3, 95% CI 1.1-1.6). In the multivariable analysis, only older age and high IGF1 concentrations at last available follow-up visit were predictors of mortality. The oncological causes of death outweighed the cardiovascular ones, bordering on statistical significance with respect to the general population.</p><p><strong>Conclusions: </strong>Mortality remains significantly high in patients with acromegaly, irrespectively of disease status, as long as the follow-up is sufficiently long with a low rate of patients lost to follow-up. Therapy strategy including radiotherapy does not have an impact on mortality. Oncological causes of death currently outweigh the cardiovascular causes.</p>","PeriodicalId":48802,"journal":{"name":"Journal of Endocrinological Investigation","volume":null,"pages":null},"PeriodicalIF":5.4000,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11142937/pdf/","citationCount":"0","resultStr":"{\"title\":\"Disease control of acromegaly does not prevent excess mortality in the long term: results of a nationwide survey in Italy.\",\"authors\":\"M Arosio, V Sciannameo, A Contarino, P Berchialla, S Puglisi, A C Pesatori, E Ferrante, M Filopanti, R Pivonello, F Dassie, V Rochira, S Cannavò, E De Menis, F Pigliaru, S Grottoli, V Cambria, M Faustini-Fustini, M Montini, A Peri, F Ceccato, E Puxeddu, G Borretta, M Bondanelli, D Ferone, A Colao, M Terzolo, G Reimondo\",\"doi\":\"10.1007/s40618-023-02257-3\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>This study aimed to assess the long-term outcome of patients with acromegaly.</p><p><strong>Design: </strong>This is a multicenter, retrospective, observational study which extends the mean observation period of a previously reported cohort of Italian patients with acromegaly to 15 years of follow-up.</p><p><strong>Methods: </strong>Only patients from the centers that provided information on the life status of at least 95% of their original cohorts were included. Life status information was collected either from clinical records or from the municipal registry offices. Standardized mortality ratios (SMRs) were computed comparing data with those of the general Italian population.</p><p><strong>Results: </strong>A total of 811 patients were included. There were 153 deaths, with 90 expected and an SMR of 1.7 (95% CI 1.4-2.0, p < 0.001). Death occurred after a median of 15 (women) or 16 (men) years from the diagnosis, without gender differences. Mortality remained elevated in the patients with control of disease (SMR 1.3, 95% CI 1.1-1.6). In the multivariable analysis, only older age and high IGF1 concentrations at last available follow-up visit were predictors of mortality. The oncological causes of death outweighed the cardiovascular ones, bordering on statistical significance with respect to the general population.</p><p><strong>Conclusions: </strong>Mortality remains significantly high in patients with acromegaly, irrespectively of disease status, as long as the follow-up is sufficiently long with a low rate of patients lost to follow-up. Therapy strategy including radiotherapy does not have an impact on mortality. Oncological causes of death currently outweigh the cardiovascular causes.</p>\",\"PeriodicalId\":48802,\"journal\":{\"name\":\"Journal of Endocrinological Investigation\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":5.4000,\"publicationDate\":\"2024-06-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11142937/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Endocrinological Investigation\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s40618-023-02257-3\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/1/12 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Endocrinological Investigation","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s40618-023-02257-3","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/12 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"Medicine","Score":null,"Total":0}
Disease control of acromegaly does not prevent excess mortality in the long term: results of a nationwide survey in Italy.
Objective: This study aimed to assess the long-term outcome of patients with acromegaly.
Design: This is a multicenter, retrospective, observational study which extends the mean observation period of a previously reported cohort of Italian patients with acromegaly to 15 years of follow-up.
Methods: Only patients from the centers that provided information on the life status of at least 95% of their original cohorts were included. Life status information was collected either from clinical records or from the municipal registry offices. Standardized mortality ratios (SMRs) were computed comparing data with those of the general Italian population.
Results: A total of 811 patients were included. There were 153 deaths, with 90 expected and an SMR of 1.7 (95% CI 1.4-2.0, p < 0.001). Death occurred after a median of 15 (women) or 16 (men) years from the diagnosis, without gender differences. Mortality remained elevated in the patients with control of disease (SMR 1.3, 95% CI 1.1-1.6). In the multivariable analysis, only older age and high IGF1 concentrations at last available follow-up visit were predictors of mortality. The oncological causes of death outweighed the cardiovascular ones, bordering on statistical significance with respect to the general population.
Conclusions: Mortality remains significantly high in patients with acromegaly, irrespectively of disease status, as long as the follow-up is sufficiently long with a low rate of patients lost to follow-up. Therapy strategy including radiotherapy does not have an impact on mortality. Oncological causes of death currently outweigh the cardiovascular causes.
期刊介绍:
The Journal of Endocrinological Investigation is a well-established, e-only endocrine journal founded 36 years ago in 1978. It is the official journal of the Italian Society of Endocrinology (SIE), established in 1964. Other Italian societies in the endocrinology and metabolism field are affiliated to the journal: Italian Society of Andrology and Sexual Medicine, Italian Society of Obesity, Italian Society of Pediatric Endocrinology and Diabetology, Clinical Endocrinologists’ Association, Thyroid Association, Endocrine Surgical Units Association, Italian Society of Pharmacology.