The five parameters selected were: IGF-1 levels (red: IGF-1 ULN > 1.2); tumor status at current MRI (red: significant increase in tumor size and/or invasiveness is observed since prior MRI and/or impaired vision); presence of GH excess comorbidities (i.e., diabetes mellitus, sleep apnea, and cardiovascular disease); symptoms (red: SSS > 4 or more symptoms rated major than 6); and health-related QoL impairment as AcroQoL results (red: AcroQoL < 40) [3]. This evidence concerns the gene IGF1 and Sleep apnea.