ECE2020 ePoster Presentations Pituitary and Neuroendocrinology (94 abstracts)
Can you predict the recurrence of cushing’s disease after surgery?
Paloma Moreno-Moreno 1 , Rosa Camara-Gómez 2 , Alfonso Soto-Moreno 3 , Carmen Fajardo-Montañana 4 , Raul M Luque 5 & María Ángeles Gálvez-Moreno 1
1University Hospital Reina Sofía, Management Unit of Clinical Endocrinology and Nutrition, Córdoba, Spain; 2University and Polytechnic Hospital La Fe, Management Unit of Clinical Endocrinology and Nutrition, Valencia, Spain; 3University Hospital Virgen del Rocío, Management Unit of Clinical Endocrinology and Nutrition, Sevilla, Spain; 4University Hospital La Ribera, Management Unit of Clinical Endocrinology and Nutrition, Alcira, Spain; 5University of Córdoba. IMIBIC, Department of Cell Biology, Physiology and Immunology, Córdoba, Spain
Objective: Remission of Cushing’s disease (CD) in the postoperative vary between 55–85%, recurrence of up to 25%. Remission and recurrence rates vary dependent on tumor size and neurosurgical expertise. The objective of this study is to describe whether there are clinical data that help us to predece recurrence of CD after transsphenoidal surgery (TSS).
Patients and Methods: Retrospective analysis of patients who underwent as TSS for CD. Variables analyzed: age, sex, time to diagnosis, tumor size, serum cortisol, salivary cortisol, urinary-free cortisol (UFC). Recurrence was defined as disturbance of serum cortisol, salivary cortisol, UFC levels and ACTH in patients in remission after TSS.
Results: 67 patients with CD treated with TSS. Women: 82.1%. Remission 71.6% (men: 3; women 45). Recurrence: 23.9% (men: 2; women 14).
| Recurrence | No recurrence | P | |
| Age (years) | 38.56 ± 14.82 | 43.03 ± 15.33 | 0.32 |
| Time from onset of symptoms to diagnosis (months) | 25 ± 22.8 | 37.29 ± 30.54 | 0.16 |
| Time from diagnosis to surgery (months) | 3.5 ± 3.1 | 7.63 ± 5.93 | 0.01 |
| Tumor size (mm) | 10.42 ± 7.34 | 9.99 ± 7.81 | 0.85 |
| Basal cortisol presurgery (µg/dl) | 25.21 ± 13.63 | 22.9 ± 8.53 | 0.47 |
| Midnight plasma cortisol presurgery (µg/dl) | 14.6 ± 3.2 | 14.47 ± 6.66 | 0.94 |
| Midnight salivary cortisol presurgery (µg/dl) | 0.2 ± 0.11 | 3.05 ± 7.06 | 0.11 |
| 24-hour urinary cortisol presurgery (µg/24 h) | 571.03 ± 407.35 | 592.31 ± 766.73 | 0.91 |
| ACTH presurgery (pg/ml) | 91.26 ± 62.91 | 76.72 ± 2.38 | 0.34 |
| Basal cortisol postsurgery (µg/dl) | 5.64 ± 5.47 | 4.79 ± 6.6 | 0.65 |
| Midnight salivary cortisol postsurgery (µg/dl) | 0.33 ± 0.24 | 0.17 ± 0.1 | 0.02 |
| ACTH postsurgery (pg/ml) | 24.59 ± 42.38 | 22.31 ± 32.55 | 0.85 |
Conclusions: Patients with recurrence of CD had higher levels of midnight salivary cortisol postsurgery. Recurrence of CD is similar to that described in the literature.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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