Original Article   

Minerva Endocrinology 2022 Oct 26

DOI: 10.23736/S2724-6507.22.03888-X

Copyright © 2022 EDIZIONI MINERVA MEDICA

language: English

May the SAGIT® instrument be used as a preoperative prognostic tool in patients with acromegaly?

Emre GEZER ¹ ✉, Berrin ÇETINARSLAN ², Zeynep CANTÜRK ², Alev SELEK ², Mehmet SÖZEN ², Damla KÖKSALAN ², Aylin BEKIROĞLU ², Ihsan ANIK ³, Savaş CEYLAN ³

¹ Department of Endocrinology and Metabolism, Darica Farabi Training and Research Hospital, Kocaeli, Turkey; ² Department of Endocrinology and Metabolism, Faculty of Medicine, University of Kocaeli, Kocaeli, Turkey; ³ Department of Neurosurgery, Faculty of Medicine, University of Kocaeli, Kocaeli, Turkey

BACKGROUND: The SAGIT® instrument has been developed for acromegaly to assist clinicians in staging the disease accurately, assessing the response to therapy, and adjusting the treatment. We aimed to evaluate the preoperative utility of the SAGIT® instrument and to discover a cut-off value for predicting the surgery outcome and long-term prognosis of patients with acromegaly.
METHODS: A total of 832 patients with acromegaly were identified from the medical record system. Acromegaly diagnosis was confirmed by elevated IGF-1 levels according to the age-adjusted upper limit of normal, lack of suppression of GH concentration to <0.4 μg/L following a 75 g oral glucose tolerance test, and the existence of a pituitary adenoma demonstrated by MRI. The SAGIT® instrument comprises five key components of acromegaly: signs and symptoms (S), associated comorbidities (A), GH levels (G), IGF-1 levels (I), and the features of the tumor (T). The initial postoperative remission was evaluated 3 months after surgery.
RESULTS: A final cohort of 132 patients has been included in our study. Median preoperative SAGIT scores were significantly different (10.00 [9.00 - 11.00] to 11.00 [10.00 - 13.00], [p = 0.002]) between patients who achieved initial remission at 3 months and those who were not in remission. The threshold SAGIT score distinguishing between initial remission and nonremission groups was 10 with an AUC of 0.660 (p < 0.001).
CONCLUSIONS: In our retrospective cohort study, the findings suggested that the SAGIT® instrument may be a beneficial preoperative tool to predict the initial remission postoperatively and long-term prognosis of the patients with acromegaly.

KEY WORDS: Acromegaly; Growth hormone secreting adenoma; SAGIT; Prognosis