Earlier post-operative hypocortisolemia may predict durable remission from Cushing’s disease

Context Achievement of hypocortisolemia following transsphenoidal surgery (TSS) for Cushing’s disease (CD) is associated with successful adenoma resection. However, up to one-third of these patients recur. Objective We assessed whether delay in reaching post-operative cortisol nadir may delineate pa...

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Veröffentlicht in:	European journal of endocrinology 2018-03, Vol.178 (3), p.255-263
Hauptverfasser:	Ironside, Natasha, Chatain, Gregoire, Asuzu, David, Benzo, Sarah, Lodish, Maya, Sharma, Susmeeta, Nieman, Lynnette, Stratakis, Constantine A, Lonser, Russell R, Chittiboina, Prashant
Format:	Artikel
Sprache:	eng
Schlagworte:	ACTH-Secreting Pituitary Adenoma - surgery Adenoma Adenoma - surgery Adrenocorticotropic hormone Area Under Curve Clinical Study Cushing's disease Hormones Humans Hydrocortisone Hydrocortisone - blood Kaplan-Meier Estimate Logistic Models Neoplasm Recurrence, Local - blood Neoplasm Recurrence, Local - epidemiology Nervous system diseases Neurosurgical Procedures Pituitary Pituitary ACTH Hypersecretion - surgery Postoperative Period Remission Remission Induction ROC Curve Surgery Time Factors
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Zusammenfassung:	Context Achievement of hypocortisolemia following transsphenoidal surgery (TSS) for Cushing’s disease (CD) is associated with successful adenoma resection. However, up to one-third of these patients recur. Objective We assessed whether delay in reaching post-operative cortisol nadir may delineate patients at risk of recurrence for CD following TSS. Methods A retrospective review of 257 patients who received 291 TSS procedures for CD at NIH, between 2003 and 2016. Early biochemical remission (serum cortisol nadir
ISSN:	0804-4643 1479-683X
DOI:	10.1530/EJE-17-0873