Prognostic Factors of Long-Term Remission After Surgical Treatment of Cushing's Disease

被引：24

作者：

Ioachimescu, Adriana G. ^{[1
]}

机构：

[1] Emory Univ, Dept Med Endocrinol & Neurosurg, Sch Med, 1365 B Clifton Rd Northeast,B6209, Atlanta, GA 30322 USA

来源：

ENDOCRINOLOGY AND METABOLISM CLINICS OF NORTH AMERICA | 2018年 / 47卷 / 02期

关键词：

Cushing's disease; ACTH-secreting pituitary adenoma; Transsphenoidal surgery; Recurrence; Outcomes; Cortisol; ACTH; TRANSSPHENOIDAL SURGERY; PITUITARY SURGERY; SERUM-CORTISOL; POSTOPERATIVE CORTISOL; IMMEDIATE REOPERATION; RECURRENCE RATES; ACTH; MANAGEMENT; OUTCOMES; MICROSURGERY;

D O I：

10.1016/j.ecl.2018.02.002

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Transsphenoidal surgery is the main treatment of patients with adrenocorticotropic hormone (ACTH)-secreting pituitary adenomas. Although biochemical remission occurs in most patients undergoing operations at specialized centers, the recurrence risk is significant. Visualization of microadenomas on preoperative imaging and confirmation of ACTH-positive adenomas have been associated with higher remission rates. Low cortisol levels in the first 2 weeks postoperatively have been associated with durable remission; however, recurrence cannot be excluded by any cortisol threshold. The decision to perform a pituitary reoperation is based on this parameter; the protocols are institution specific. Patients with Cushing's disease warrant lifelong endocrinologic surveillance.

引用

页码：335 / +

页数：14

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