SAT-085 Residing Rurally Is Associated With Lower Remission Rates in Acromegaly

Abstract Disclosure: J. Mann: None. J. Riva-Cambrin: None. Y. Starreveld: None. K. Lithgow: None. Background: Acromegaly is a rare disease caused by a growth hormone-secreting pituitary adenoma which results in potentially debilitating skeletal, cardiac and gastrointestinal disease. Surgical resection can be curative, however, not all patients live in close geographic proximity to a tertiary centre with skull base neurosurgeons and multidisciplinary expertise (endocrinology, radiation oncology, ophthalmology). We sought to assess disparities in surgical outcomes for patients with acromegaly in the province of Alberta, Canada based on residing rurally or within the urban tertiary centre (city of Calgary). Our primary aim was assessment of post-operative remission rates by rural versus urban residence. Methods: This study was a combined retrospective chart review and prospective questionnaire of demographic, endocrinological, and surgical variables, and patient-reported outcome measures (PROMs) in acromegaly patients treated surgically over a decade (June 2012- November 2022). Assessment between sociodemographic variables and surgical remission rates was performed using Chi2 or Fisher’s exact test, and comparison between sociodemographic variables and PROMs was performed using ANOVA. Statistical analysis was performed using Stata Version 17. Results: Our cohort included 74 surgically treated acromegaly patients (57% male), with a mean age of 46.3 years (SD14.4), all treated via transsphenoidal surgery (77% endoscopic). Rural versus urban residence was associated with early post-operative remission: 58.2% in the urban cohort versus 31.6% in the rural cohort (p=0.045), and current post-operative remission: 87.0% in the urban cohort (24.0% with adjuvant therapy) versus 84.0% in the rural cohort (52.6% with adjuvant therapy) (p=0.044). Rurally residing patients tended to present with larger adenomas (18.4mm versus 16.5mm in urban residing; p=0.83), and longer mean time from symptom-onset to diagnosis (44.2 months versus 27.7 months in urban residing; p=0.30). The median Acromegaly Quality of Life Score (AcroQoL) was 83 (N=40), and AcroQoL did not differ significantly by residence location or any additional sociodemographic variable. Conclusions: In this large, comprehensive, single-centre cohort of surgically treated acromegaly patients, residing rurally was associated with lower rates of early and current post-operative remission. We hypothesize that geographic barriers may contribute to delays in diagnosis and treatment in rurally residing patients. Presentation: Saturday, July 12, 2025