Outcome of Transsphenoidal Surgery for Cushing Disease: A Single-Center Experience over 20 Years

World Neurosurgery
Camille BrichardChristian Raftopoulos

Abstract

This study investigated the outcome of transsphenoidal surgery (TSS) for Cushing disease (CD) and the influence of our surgical strategy on remission rates and postoperative pituitary function. We retrospectively reviewed data from 71 patients with CD who underwent microscope navigation TSS (MN-TSS) in Saint-Luc Hospital between 1996 and 2017. True remission was defined as normal fasting cortisol level, normal 24-hour urinary free cortisol, or continued need for hydrocortisone replacement for 1 year after surgery. Overall remission rate after 1 or repeated MN-TSS was 83%. Highest remission rate was found in patients with macroadenomas (92%). Successful first MN-TSS was correlated with a high final remission rate (95%), whereas failed first MN-TSS was correlated with a low final remission rate (36%). Although day 1 cortisol levels were significantly lower in patients with long-term remission, high levels were still observed in a few patients, especially those who had had CD for many years. We found a low rate of postoperative pituitary long-term hypofunction (9.7%). MN-TSS is a safe and effective procedure to treat CD, allowing remission rates of 83%. One-year remission period after first surgery is correlated with a final remis...Continue Reading

Citations

Nov 16, 2019·Journal of Clinical Medicine·Hiroshi Nishioka, Shozo Yamada
Oct 31, 2019·The Journal of Clinical Endocrinology and Metabolism·German RubinsteinMartin Reincke
Nov 28, 2019·Journal of Endocrinological Investigation·A L SerbanE Ferrante
Aug 20, 2020·Expert Review of Endocrinology & Metabolism·Cristina CapatinaMaria Fleseriu
Oct 2, 2020·The Journal of Clinical Endocrinology and Metabolism·Yanghua FanRenzhi Wang
Oct 28, 2020·The Journal of Clinical Endocrinology and Metabolism·Fang WangLe Min
Jan 22, 2021·Best Practice & Research. Clinical Endocrinology & Metabolism·José Miguel Hinojosa-Amaya, Daniel Cuevas-Ramos
Mar 7, 2020·Best Practice & Research. Clinical Endocrinology & Metabolism·Oskar Ragnarsson
May 22, 2021·Modern Pathology : an Official Journal of the United States and Canadian Academy of Pathology, Inc·Sylvia L AsaUNKNOWN Attendees of the 15th Meeting of the International Pituitary Pathology Club, Istanbul October 2019

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