The Influence of Pituitary Size on Outcome After Transsphenoidal Hypophysectomy in a Large Cohort of Dogs with Pituitary-Dependent Hypercortisolism
| Autor: | van Rijn, Sarah, Galac, S., Tryfonidou, M. A., Hesselink, J. W., Penning, L. C., Kooistra, H. S., Meij, B. P., dCSCA RMSC-1, dCSCA RMSC-2, Opleiding chirurgie, Sub Endocrinologie, Orthopedie en neurochirurgie, Geneeskunde van gezelschapsdieren, Zorgfaciliteiten leiding, Onderzoek, LS Algemene chirurgie, dCSCA AVR |
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| Přispěvatelé: | dCSCA RMSC-1, dCSCA RMSC-2, Opleiding chirurgie, Sub Endocrinologie, Orthopedie en neurochirurgie, Geneeskunde van gezelschapsdieren, Zorgfaciliteiten leiding, Onderzoek, LS Algemene chirurgie, dCSCA AVR |
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
Pituitary gland Hypophysectomy 040301 veterinary sciences Urinary system medicine.medical_treatment Kaplan-Meier Urology 030209 endocrinology & metabolism Standard Article Urine Canine 0403 veterinary science 03 medical and health sciences Basal (phylogenetics) Endocrinology Dogs 0302 clinical medicine Recurrence Animals Medicine Dog Diseases Pituitary ACTH Hypersecretion Survival analysis General Veterinary business.industry Kaplan‐Meier Pituitary ACTH hypersecretion 04 agricultural and veterinary sciences Cushing's disease medicine.disease Pituitary surgery Survival Analysis Standard Articles Surgery medicine.anatomical_structure Pituitary Gland SMALL ANIMAL business |
| Zdroj: | Journal of Veterinary Internal Medicine, 30(4), 989. Wiley-Blackwell Journal of Veterinary Internal Medicine |
| ISSN: | 0891-6640 |
| Popis: | Background Transsphenoidal hypophysectomy is one of the treatment strategies in the comprehensive management of dogs with pituitary‐dependent hypercortisolism (PDH). Objectives To describe the influence of pituitary size at time of pituitary gland surgery on long‐term outcome. Animals Three‐hundred–and‐six dogs with PDH. Methods Survival and disease‐free fractions were analyzed and related to pituitary size; dogs with and without recurrence were compared. Results Four weeks after surgery, 91% of dogs were alive and remission was confirmed in 92% of these dogs. The median survival time was 781 days, median disease‐free interval was 951 days. Over time, 27% of dogs developed recurrence of hypercortisolism after a median period of 555 days. Dogs with recurrence had significantly higher pituitary height/brain area (P/B) ratio and pre‐operative basal urinary corticoid‐to‐creatinine ratio (UCCR) than dogs without recurrence. Survival time and disease‐free interval of dogs with enlarged pituitary glands was significantly shorter than that of dogs with a non‐enlarged pituitary gland. Pituitary size at the time of surgery significantly increased over the 20‐year period. Although larger tumors have a less favorable prognosis, outcome in larger tumors improved over time. Conclusions and Clinical Importance Transsphenoidal hypophysectomy is an effective treatment for PDH in dogs, with an acceptable long‐term outcome. Survival time and disease‐free fractions are correlated negatively with pituitary gland size, making the P/B ratio an important pre‐operative prognosticator. However, with increasing experience, and for large tumors, pituitary gland surgery remains an option to control the pituitary mass and hypercortisolism. |
| Databáze: | OpenAIRE |
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