TABLE 2.

Comparison of the endocrine outcomes, tumor control rates, ARE, and additional treatments between the matched upfront versus postoperative SRS cohorts

Outcomes	Primary SRS	Postop SRS	p Value
Endocrine outcome
Initial endocrine remission	10 (38%)	24 (46.1%)	0.52
Durable remission	6 (23%)	11 (21%)	0.84
Biochemical recurrence after initial remission	4 (15%)	13 (25%)	0.33
IGF-1 normalization on meds	8 (30.7%)	16 (30.7%)	1.0
IGF-1 normalization either on or off meds	18 (69%)	40 (76.9%)	0.46
Random GH <1 μg/L off meds	8 (30.7%)	23 (44.2%)	0.25
Random GH <1 μg/L on meds	6 (23.0%)	16 (30.7%)	0.47
Random GH <1 μg/L, either on or off meds	14 (53.8%)	39 (75%)	0.06
IGF-1 normalization and GH <1 μg/L off meds*	5 (19.2%)	19 (36.5%)	0.12
Median time to IGF-1 normalization, mos	24.5 (10–61.6)	39 (9–142)	0.06
Median time to recurrence after normalization of IGF-1, mos	4.4 (2.2–16)	7.3 (3.3–48)	0.06
Tumor control
Radiological tumor regression	18 (69.2%)	37 (71.1%)	0.86
Radiologically stable tumor size	8 (30.7%)	13 (25%)	0.59
Radiological tumor control	26 (100%)	50 (96.1%)	0.32
ARE
New-onset hypopituitarism	4 (15.3%)	10 (19.2%)	0.67
Single hormone deficiency	2 (7.6%)	7 (13.4%)	0.45
Multiple hormone deficiency	2 (7.6%)	3 (5.7%)	0.74
TSH deficiency	2 (7.6%)	5 (9.6%)	0.08
Testosterone deficiency	2 (7.6%)	4 (7.6%)	1.0
Cortisol deficiency	1 (3.8%)	3 (5.7%)	0.61
Cranial neuropathy excluding visual function	0	0	—
New visual deficits	1 (3.8%)	1 (1.9%)	0.25
Mortality related to Tx	0	0	—
Additional Txs
Resection after SRS	1 (3.8%)	0	—
Repeat GKRS after initial SRS	4 (15.3%)	1 (1.9%)	0.02

GKRS = Gamma Knife radiosurgery; meds = medications; TSH = thyroid-stimulating hormone; — = statistical analysis not done. All values are expressed as either the number of patients (%) or the median with range, as indicated.

^*2010 acromegaly consensus criteria for remission or cure.