Results and predictors of outcome of endoscopic endonasal surgery in Cushing's disease: 20-year experience of an Italian referral Pituitary Center
| Autor: | Federica Guaraldi, Sofia Asioli, Antonella Bacci, Giovanni Corona, Diego Mazzatenta, Ernesto Pasquini, Davide Gori, Alessandra Sforza, Filippo Friso, Matteo Zoli |
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| Přispěvatelé: | Guaraldi, F, Zoli, M, Asioli, S, Corona, G, Gori, D, Friso, F, Pasquini, E, Bacci, A, Sforza, A, Mazzatenta, D |
| Rok vydání: | 2019 |
| Předmět: |
Adenoma
Adult Male medicine.medical_specialty Endoscopic endonasal surgery Endocrinology Diabetes and Metabolism medicine.medical_treatment 030209 endocrinology & metabolism Hypopituitarism Nose Cortisol Neurosurgical Procedures 03 medical and health sciences Young Adult 0302 clinical medicine Endocrinology medicine Humans Pituitary unit Pituitary ACTH Hypersecretion Referral and Consultation Outcome Retrospective Studies Transsphenoidal surgery business.industry Retrospective cohort study Endoscopy Cushing's disease Cushing’s disease Middle Aged medicine.disease Prognosis Magnetic Resonance Imaging Surgery ACTH-Secreting Pituitary Adenoma Treatment Outcome Italy 030220 oncology & carcinogenesis Pituitary carcinoma Cavernous sinus Diabetes insipidus Female business Predictor |
| Zdroj: | Journal of endocrinological investigation. 43(10) |
| ISSN: | 1720-8386 |
| Popis: | To assess outcomes and predictors of early and long-term remission in patients with Cushing’s disease (CD) due to ACTH-secreting adenomas treated via endoscopic endonasal approach (EEA). This is a retrospective study. Consecutive patients operated for CD from 1998 to 2017 in an Italian referral Pituitary Center were enrolled. Clinical, radiological, and histological data at enrollment and follow-up were collected. 151 patients (107 F) were included; 88.7% were naive for treatment, 11.3% had been treated surgically and 11.2% medically. At pre-operative magnetic resonance imaging (MRI), 35 had a macroadenoma and 80 a microadenoma, while tumor was undetectable in 36 patients. Mean age at surgery was 41.1 ± 16.6 years. Diagnosis was confirmed histologically in 82.4% of the cases. Patients with disease persistence underwent second surgery and/or medical and/or radiation therapy. Mean follow-up was 92.3 ± 12.0 (range 12–237.4) and median 88.2 months. Remission rate was 88.1% after the first surgery and 90.7% at last follow-up. One patient died of pituitary carcinoma. Post-surgical cortisol drop (p = 0.004), tumor detection at MRI (p = 0.03) and size |
| Databáze: | OpenAIRE |
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