Reference : Factors influencing the immediate and late outcome of cushing-disease treated by transsp...
Scientific journals : Article
Human health sciences : Endocrinology, metabolism & nutrition
http://hdl.handle.net/2268/64110
Factors influencing the immediate and late outcome of cushing-disease treated by transsphenoidal surgery : A retrospective study by the european cushings-disease survey group
English
Bochicchio, D. [ > > ]
Losa, M. [ > > ]
Buchfelder, M. [ > > ]
Stevenaert, Achille [Université de Liège - ULg > > Neurochirurgie >]
Beckers, Albert mailto [Université de Liège - ULg > Département des sciences cliniques > Endocrinologie >]
Hagen, C. [ > > ]
Bjerke, P. [ > > ]
Kruse, A. [ > > ]
Lindholm, J. [ > > ]
Fahlbusch, R. [ > > ]
Muller, O. A. [ > > ]
Vonwerder, K. [ > > ]
Ambrosi, B. [ > > ]
Faglia, G. [ > > ]
Giovanelli, M. [ > > ]
Angeli, A. [ > > ]
Maira, G. [ > > ]
Pieters, GFFM [ > > ]
Carvalho, D. [ > > ]
Medina, J. L. [ > > ]
Costa, C. [ > > ]
Teles, A. G. [ > > ]
Guerreiro, L. [ > > ]
Salcedo, I. [ > > ]
Dolenc, V. [ > > ]
Jezernik, M. [ > > ]
Vazquez, J. A. [ > > ]
Gaztambide, S. [ > > ]
Webb, S. M. [ > > ]
Halperin, I. [ > > ]
Valerdell, E. [ > > ]
Vidal, O. [ > > ]
Sanchez-Franco, F. [ > > ]
Astorga, R. [ > > ]
Lealcerro, A. [ > > ]
Luna, P. P. G. [ > > ]
Torres, E. [ > > ]
Thoren, M. [ > > ]
Werner, S. [ > > ]
Landolt, A. M. [ > > ]
Atkinson, A. B. [ > > ]
Mccace, D. R. [ > > ]
Gordon, D. S. [ > > ]
Hadden, D. R. [ > > ]
Kennedy, L. [ > > ]
Scanlon, M. F. [ > > ]
Cruickshanks, G. [ > > ]
Teasdale, G. M. [ > > ]
Nov-1995
Journal of Clinical Endocrinology and Metabolism
Endocrine Society
80
11
3114-3120
Yes (verified by ORBi)
International
0021-972X
Chevy Chase
MD
[en] pituitary adenoma ; hypercortisolism ; Cushing's disease ; surgical treatment ; transsphenoidal surgery
[en] Hypercortisolism attributable to hypersecretion of ACTH by a pituitary adenoma is an uncommon and progressively lethal disease. Because of its rarity, it has been difficult to collect a large series of patients in order to identify the prognostic factors influencing the outcome after transsphenoidal surgery. We conducted a multicenter, retrospective analysis of the early and late results of surgical treatment of Cushing's disease. Files of patients with Cushing's disease who underwent transsphenoidal surgery between 1975 and 1990 were collected from 25 institutions throughout Europe. Data from 668 of 716 patients were suitable for statistical analyses. Surgical mortality was 1.9%, and major morbidity occurred in 97 patients (14.5%). Clinical and biochemical remission of Cushing's disease after surgery occurred in 510 cases (76.3%). Identification of the tumor by neuroradiological imaging or at operation with histopathological corroboration was associated with remission of hypercortisolism. Recurrence of the disease occurred in 65 (12.7%) of 510 patients in remission after surgery at a mean time of 39.3 months (range 6-104 months). The distribution of the recurrences did not show any apparent plateau or cluster throughout the follow-up period. Low postoperative steroid levels, absence of cortisol response to CRH, and the need for long-term glucocorticoid substitution therapy were all associated with a high probability of long-term remission. Our study demonstrates that transsphenoidal surgery is a safe and effective treatment for patients with Cushing's disease. However, after successful surgery there is a steady increase in the percentage of recurrences, which continues with time. Patients who after operation had hypoadrenocorticism and needed long-term glucocorticoid substitution therapy had the lowest risk of relapse.
Researchers ; Professionals
http://hdl.handle.net/2268/64110

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