Somatostatin Therapy and Surgical Outcomes in Acromegaly: Insights From a Systematic Review and Meta-analysis

The management of acromegaly, a chronic hormone disorder characterized by excessive growth hormone (GH) secretion, remains a subject of debate. This systematic review and meta-analysis aim to evaluate the impact of preoperative somatostatin analog (SA) treatment on surgical outcomes in acromegaly patients. A comprehensive search of medical databases was conducted following PRISMA guidelines, resulting in the inclusion of 15 studies published between 2013 and 2024, encompassing 4,387 patients with an average age of 46-47 years. The primary outcomes analyzed were surgical remission rates, postoperative GH levels, tumor volume reduction, and complication rates. Studies indicate that preoperative SA treatment significantly improves remission rates and reduces postoperative GH levels compared to surgery alone. For instance, one study reported a biochemical control rate of 59.5% in the SA group versus 46.5% in the non-SA group. Another study showed that preoperative SA treatment led to a higher rate of tumor volume reduction (62.5% vs. 53.7%). Additionally, patients treated with SAs experienced fewer surgical complications and higher rates of biochemical control. Despite the higher initial costs associated with SA treatment, long-term benefits such as reduced complications and enhanced surgical outcomes suggest it is a cost-effective approach. However, the analysis also highlights the need for further research on long-term outcomes, recurrence rates, patient quality of life, and the overall costeffectiveness of preoperative SA treatment. This study provides evidence supporting the integration of medical management into the preoperative care plan for acromegaly patients, emphasizing the potential benefits of SA treatment in improving surgical outcomes.