Cushing’s syndrome: Pituitary surgery alone is the preferred treatment to improve survival

Background

No agreement has been reached on the long-term survival prospects for patients with Cushing’s disease. We studied life expectancy in patients who had received curative treatment and whose hypercortisolism remained in remission for more than 10 years, and identified factors determining their survival.

Methods

We did a multicentre, multinational, retrospective cohort study using individual case records from specialist referral centres in the UK, Denmark, the Netherlands, and New Zealand. Inclusion criteria for participants, who had all been in studies reported previously in peer-reviewed publications, were diagnosis and treatment of Cushing’s disease, being cured of hypercortisolism for a minimum of 10 years at study entry, and continuing to be cured with no relapses until the database was frozen or death. We identified the number and type of treatments used to achieve cure, and used mortality as our primary endpoint. We compared mortality rates between patients with Cushing’s disease and the general population, and expressed them as standardised mortality ratios (SMRs). We analysed survival data with multivariate analysis (Cox regression) with no corrections for multiple testing.

Read more at http://www.univadis.com/viewarticle/cushing-s-syndrome-pituitary-surgery-alone-is-the-preferred-treatment-to-improve-survival-421761

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