Pituitary Disorders/Neuroendocrinology
R Chen, J Levi, M Almalki, S Yi, M Johnson, E Ur
Summary: The objective of this study was to describe the management and outcomes of patients with Cushing’s disease (CD) in the Vancouver region over a 30-year period and to investigate the predictive factors of CD recurrence. Researchers found CD recurrence in 45.8% of patients who received initial transsphenoidal surgery (TSS), and that a post-operative serum cortisol level > 140nmol/L may be a positive predictor of recurrence in these patients.
Methods:
- Researchers retrospectively reviewed the clinical charts from endocrinologists in Vancouver who provided consent to participate in this study.
- Included in this study were 48 patients diagnosed with CD since 1985.
Results:
- All 48 patients received initial TSS; the mean follow-up time was 11.73 (±6.98) years.
- More than half of the patients (n=26, 54.2%) remained in remission, and 22 patients (45.8%) received subsequent interventions due to CD recurrence.
- Second-line therapies included repeat TSS (40.9%), stereotactic radiotherapy (18.2%), and bilateral adrenalectomy (36.4%).
- Among patients with disease recurrence, the average post-operative serum cortisol level was significantly higher (489.0 nmol/L vs 114.7nmol/L; P=0.003).
- The positive predictive value for recurrence with post-operative serum cortisol > 140nmol/L was 76.5% (P=0.049), while serum cortisol < 140nmol/L had an 80% predictive value for non-recurrence (P=0.035).
Filed under: 25th Annual Congress of the American Association of Clinical Endocrinologists, Cushing's, Meetings and Conferences, Treatments | Tagged: 25th Annual Congress of the American Association of Clinical Endocrinologists, abstract, bilateral laparoscopic adrenalectomy, BLA, conference, Cushing's Disease, pituitary, recurrence, serum cortisol, stereotactic radiation, transsphenoidal |
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