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Titolo:
FACTORS INFLUENCING THE IMMEDIATE AND LATE OUTCOME OF CUSHINGS-DISEASE TREATED BY TRANSSPHENOIDAL SURGERY - A RETROSPECTIVE STUDY BY THE EUROPEAN CUSHINGS-DISEASE SURVEY GROUP
Autore:
BOCHICCHIO D; LOSA M; BUCHFELDER M; STEVENAERT A; BECKERS A; HAGEN C; BJERRE P; KRUSE A; LINDHOLM J; FAHLBUSCH R; MULLER OA; VONWERDER K; AMBROSI B; FAGLIA G; GIOVANELLI M; ANGELI A; MAIRA G; PIETERS GFFM; CARVALHO D; MEDINA JL; COSTA C; TELES AG; GUERREIRO L; RUAS M; SALCEDO I; DOLENC V; JEZERNIK M; VAZQUEZ JA; GAZTAMBIDE S; WEBB SM; HALPERIN I; VILARDELL E; VIDAL O; SANCHEZFRANCO F; ASTORGA R; LEALCERRO A; LUNA PPG; TORRES E; THOREN M; WERNER S; LANDOLT AM; ATKINSON AB; MCCANCE DR; GORDON DS; HADDEN DR; KENNEDY L; SCANLON MF; CRUICKSHANKS G; TEASDALE GM;
Indirizzi:
UNIV MILAN,OSPED MAGGIORE,IRCCS,IST SCI ENDOCRINE,VIA FRANCESCO SFORZA 35 I-20122 MILAN ITALY UNIV MILAN,OSPED SAN RAFFAELE,IRCCS,DEPT NEUROSURG I-20122 MILAN ITALY UNIV ERLANGEN NURNBERG,DEPT NEUROSURG W-8520 ERLANGEN GERMANY UNIV LIEGE,HOP SART TILMAN,DEPT NEUROSURG B-4000 LIEGE BELGIUM UNIV LIEGE,HOP SART TILMAN,DEPT ENDOCRINOL B-4000 LIEGE BELGIUM ODENSE UNIV HOSP,DEPT NEUROSURG DK-5000 ODENSE DENMARK UNIV COPENHAGEN HOSP,RIGSHOSP,DEPT NEUROSURG DK-2100 COPENHAGEN DENMARK ROTKREUZ KRANKENHAUS,DEPT INTERNAL MED MUNICH GERMANY FREE UNIV BERLIN,SCHLOSSPK KLIN,DEPT INTERNAL MED BERLIN GERMANY UNIV TURIN,DEPT INTERNAL MED 2 ORBASSANO ITALY HOSP SAN JOAO,DEPT ENDOCRINOL OPORTO PORTUGAL HOSP CURRY CABRAL,DEPT ENDOCRINOL LISBON PORTUGAL HOSP SANTA MARIA,DEPT ENDOCRINOL LISBON PORTUGAL HOSP EGAS MONIZ,DEPT ENDOCRINOL LISBON PORTUGAL UNIV COIMBRA HOSP,DEPT ENDOCRINOL COIMBRA PORTUGAL HOSP GERAL ST ANTONIO,DEPT ENDOCRINOL OPORTO PORTUGAL UNIV LJUBLJANA,DEPT NEUROSURG LJUBLJANA SLOVENIA HOP CRUCES BILBAO SPAIN HOP CLIN & PROV BARCELONA SPAIN HOP CANALEJO LA CORUNA SPAIN CTR SALUD CARLOS III MADRID SPAIN HOP VIRGEN ROCIO SEVILLE SPAIN KAROLINSKA HOSP,DEPT ENDOCRINOL & METAB S-10401 STOCKHOLM SWEDEN AMI KLIN,DEPT NEUROSURG ZURICH SWITZERLAND ROYAL VICTORIA HOSP,METAB UNIT BELFAST BT12 6BA ANTRIM NORTH IRELAND UNIV WALES COLL MED,DEPT MED CARDIFF CF4 4XN S GLAM WALES SO GEN HOSP,INST NEUROL SCI GLASGOW G51 4TF LANARK SCOTLAND ODENSE UNIV HOSP,DEPT INTERNAL MED & ENDOCRINOL DK-5000 ODENSE DENMARK UNIV CATTOLICA SACRO CUORE,POLICLIN GEMELLI,DEPT NEUROSURG ROME ITALY UNIV NIJMEGEN,ST RADBOUD HOSP,DEPT MED,DIV ENDOCRINOL NIJMEGEN NETHERLANDS HOP S CREU & S PAU BARCELONA SPAIN
Titolo Testata:
The Journal of clinical endocrinology and metabolism
fascicolo: 11, volume: 80, anno: 1995,
pagine: 3114 - 3120
SICI:
0021-972X(1995)80:11<3114:FITIAL>2.0.ZU;2-X
Fonte:
ISI
Lingua:
ENG
Soggetto:
CORTICOTROPIN-RELEASING HORMONE; TRANS-SPHENOIDAL MICROSURGERY; TERM FOLLOW-UP; SURGICAL-TREATMENT; DIFFERENTIAL-DIAGNOSIS; ENDOCRINE FUNCTION; PITUITARY SURGERY; ADENOMAS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
43
Recensione:
Indirizzi per estratti:
Citazione:
D. Bochicchio et al., "FACTORS INFLUENCING THE IMMEDIATE AND LATE OUTCOME OF CUSHINGS-DISEASE TREATED BY TRANSSPHENOIDAL SURGERY - A RETROSPECTIVE STUDY BY THE EUROPEAN CUSHINGS-DISEASE SURVEY GROUP", The Journal of clinical endocrinology and metabolism, 80(11), 1995, pp. 3114-3120

Abstract

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 underwenttranssphenoidal 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 majormorbidity 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 39.3months (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 therapyhad the lowest risk of relapse.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 22/09/20 alle ore 07:53:38