Endocrine Abstracts

Aim of the study: To evaluate effectiveness of pituitary transsphenoidal surgery (TSS) in patients with ACTH-dependent Cushing’s syndrome (ACTH-DCS) in Republic of Uzbekistan (RUZ).

Materials and methods: Patients who included in CS register monitored in 2015. All data from 2000 to 2015 analyzed including outpatient, inpatient examines, tests and treatment. To present, 158 patients with ACTH-DCS registered and monitored. Of these 158 patients, 41 males (26%) and 117 females (74%). Mean age of patient varied from 12 to 38 years old. Mean age was 26.38±3.4 and 27.58±3.4 years old for males and females respectively. Duration of the condition varied from 4 months to 25 years. 73 patients who had TSS were evaluated in 1, 3, 6 and 12 months period of time and the every 3 months for the follow-up period. TSS was performed initially in 73 patients and in ten patients it was carried out after medical treatment.

Results: Of 158 patients, 86 patients (54%) had surgery including 73 cases who underwent TSS. Pituitary surgery performed as a monotherapy in 32 patients (44%) and in 41 cases (56%) patients received combination therapy. Of 73 patients who underwent TSS, in 60 cases (82%) patients had cured, while repeat surgery performed in ten cases (13.7%). After repeat surgery all ten patients (13.7%) had remission, however, four of them relapsed in 15 months in average. After TSS remission was achieved in 82% of patients who included 62 patients with microadenomas (84.9%) and 12 cases with macroadenimas (16.6%). After 3 years of follow-up five patients (6.8%) who had total hypophisisectomy procedure developed no relapse, whereas of 62 patients (84.9%) with selective adenomectomy and of six patients (6.8%) who had hemihypophysisectomy recurrent disease observed in 5 (8.1%) and 1 (16.7%) cases respectively while remission has not developed in 6 (9.7%) and 1 (16.7%) respectively (P=0.03).

Conclusion: Of 73 patients with CS who had pituitary surgery, remission observed in 60 patients (82%), whereas six patients (8.2%) relapsed and in seven cases (9.6%) remission has not developed. TSS remains as first treatment choice in CS and contributes to a steady remission in 82% according to our results.