Utility of the immediate postoperative cortisol concentrations in patients with Cushing's disease

Neurosurgery
Michael E SughrueLewis S Blevins

Abstract

Several investigators have recommended serial measurements of serum cortisol in the days following pituitary surgery to identify patients at risk of recurrence. We systematically reviewed the literature on this topic and analyzed the usefulness of this test in our own patient population. We identified studies publishing data regarding recurrence rates after transsphenoidal surgery for Cushing's disease, focusing on studies with data regarding patients with early postoperative cortisol levels. We determined a cumulative relative risk of having a subnormal vs normal cortisol level postoperatively using a fixed-effects meta-analysis model. Additionally, we analyzed our own patients with Cushing's disease undergoing transsphenoidal surgery and performed Kaplan-Meier analysis of recurrence-free survival for patients with undetectable, subnormal but detectable, and normal immediate 8 AM serum cortisol levels. Fourteen studies met inclusion criteria. The length of follow-up varied between 32 and 115 months. The cumulative rate of recurrence in the group of patients with subnormal cortisol levels was 9% (95% confidence interval: 6%-12%). The cumulative rate of recurrence in the group with normal cortisol levels was 24% (95% confidence ...Continue Reading

References

Oct 1, 1989·Journal of Neurosurgery·R B FriedmanD L Loriaux
Jan 1, 1994·Journal of Neurosurgery·Z RamE H Oldfield
Jan 1, 1993·Clinical Endocrinology·D R McCanceA B Atkinson
Feb 1, 1993·The Journal of Clinical Endocrinology and Metabolism·G C TomsJ P Monson
Dec 13, 2003·The Journal of Clinical Endocrinology and Metabolism·Alberto M PereiraJohannes A Romijn
Mar 6, 2004·The Journal of Clinical Endocrinology and Metabolism·G A F S RollinM A Czepielewski
Dec 8, 2004·The Journal of Clinical Endocrinology and Metabolism·Gary D HammerCharles B Wilson
Jun 16, 2005·The Journal of Clinical Endocrinology and Metabolism·Marco LocatelliEdward R Laws
Oct 20, 2005·The Journal of Clinical Endocrinology and Metabolism·Felice EspositoDaniel F Kelly

❮ Previous
Next ❯

Citations

Feb 13, 2014·Journal of Neuro-oncology·Kelley J MoloneyMarc R Mayberg
Jan 28, 2014·Journal of Neurosurgery·Paul KlimoFrederick A Boop
Oct 8, 2011·Current Problems in Surgery·Philip W Smith, John B Hanks
Jan 3, 2013·Clinical Endocrinology·Mattia BarbotCarla Scaroni
Aug 8, 2014·Endocrine Practice : Official Journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists·Elizabeth M Lamos, Kashif M Munir
Feb 24, 2015·Pituitary·Martin J RutkowskiLewis S Blevins
Feb 3, 2015·Neurosurgical Focus·Arjun V PendharkarLaurence Katznelson
May 3, 2011·Journal of Neurosurgery. Pediatrics·Phiroz E TaraporeSandeep Kunwar
Jun 13, 2015·Endocrine Reviews·Rosario PivonelloAnnamaria Colao
Jul 6, 2012·Journal of Neuro-oncology·Donald A Ross, Justin S Cetas
Jun 6, 2012·Arquivos brasileiros de endocrinologia e metabologia·Fabíola CostenaroMauro A Czepielewski

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.