Affiliation:
1. Department of Internal Medicine, Kocaeli University, Kocaeli,
Turkey
2. Department of Endocrinology and Metabolism, Pituitary Center, Kocaeli
University, Kocaeli, Turkey
3. Department of Neurosurgery, Pituitary Center, Kocaeli University,
Kocaeli, Turkey
Abstract
AbstractCushing’s disease (CD) is characterized by endogenous hypercortisolism
that is associated with increased mortality and morbidity. Due to high
recurrence rates in CD, the determination of high-risk patients is of paramount
importance. In this study, we aimed to determine recurrence rates and clinical,
laboratory, and histological predictors of recurrence in a high volume
single-center. This retrospective study included 273 CD patients operated in a
single pituitary center between 1997 and 2020. The patients with early
postoperative remission were further grouped according to recurrence status
(recurrent and sustained remission groups). Demographic, radiologic, laboratory,
pathologic, and follow-up clinical data of the patients were analyzed and
compared between groups. The recurrence rate was 9.6% in the first 5
years; however, the overall recurrence rate was 14.2% in this study.
Higher preoperative basal ACTH levels were significantly correlated with CD
recurrence even with ACTH levels adjusted for tumor size, Ki-67 levels, and
tumoral invasion. Recurrence rates were significantly higher in patients with
ACTH levels higher than 55 pg/ml, tumor
diameter>9.5 mm, and if adrenal axis recovery was before 6
months. The severity of hypercortisolism, morbidities, and demographic factors
except age were not predictive factors of recurrence. Based on our study data,
younger age at diagnosis, a diagnosis of osteoporosis, higher preoperative ACTH
levels, larger tumor size, invasive behavior, higher Ki 67 index, and early
recovery of the adrenal axis during the postoperative period attracted attention
as potential predictors of recurrent disease.
Subject
Biochemistry (medical),Clinical Biochemistry,Endocrinology,Biochemistry,General Medicine,Endocrinology, Diabetes and Metabolism
Cited by
1 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献
1. Cushing's Syndrome in the Elderly;Experimental and Clinical Endocrinology & Diabetes;2024-05-02