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• W2033505874 abstract "Summary Objective There have been a few reports on long‐term remission rates after apparent early remission following pituitary surgery in the management of Cushing's disease. An undetectable postoperative serum cortisol has been regarded as the result most likely to predict long‐term remission. Our objective was to assess the relapse rates in patients who underwent transsphenoidal surgery in order to determine whether undetectable cortisol following surgery was predictive of long‐term remission and whether it was possible to have long‐term remission when early morning cortisol was measurable but not grossly elevated. Endocrinological factors associated with late relapse were also studied. Patients We reviewed the long‐term outcome in 63 patients who had pituitary surgery for the treatment of Cushing's disease between 1979 and 2000. Measurements Case notes were reviewed and the current clinical and biochemical status assessed. Our usual practice was that early after the operation, an 08:00 h serum cortisol was measured 24 h after the last dose of hydrocortisone. This was followed by a formal low‐dose dexamethasone suppression test. Current clinical status and recent 24‐h urinary free cortisol values were used as an index of activity of the Cushing's disease. If there was evidence suggesting relapse, a low‐dose dexamethasone suppression test was performed. In many patients, sequential collections of early morning urine specimens for urinary cortisol to creatinine ratio were also performed in an attempt to diagnose cyclical and intermittent forms of recurrent hypercortisolism. We did this if there was conflicting endocrine data, or if patients were slow to lose abnormal clinical features. Results Mean age at diagnosis was 40·3 years (range 14–70 years). Mean follow‐up up time was 9·6 years (range 1–21 years). Forty‐five patients (9 males/36 females) achieved apparent remission immediately after surgery and were subsequently studied long term. Of these 45 patients, four have subsequently died while in remission from hypercortisolism. Ten of the remaining 41 patients have relapsed. Of those 10, six demonstrated definite cyclical cortisol secretion. Two of the 10 had undetectable basal serum cortisol levels in the immediate postoperative period. Thirty‐one patients are still alive and in remission. Fourteen (45%) of the 31 who remained in remission had detectable serum cortisol levels (> 50 nmol/l) immediately postoperatively, and remain in remission after a mean of 8·8 years. Our relapse rate was therefore 10/45 (22%), after a mean follow‐up time of 9·6 years, with mean time to relapse 5·3 years. Conclusions The overall remission rate of 56% (35/63) at 9·6 years follow‐up is disappointing and merits some re‐appraisal of the widely accepted principle that pituitary surgery must be the initial treatment of choice in pituitary‐dependent Cushing's syndrome. Following pituitary surgery, careful ongoing expert endocrine assessment is mandatory as the incidence of relapse increases with time and also with increasing rigour of the endocrine evaluation. A significant number of our patients were shown to have relapsed with a cyclical form of hypercortisolism." @default.
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• W2033505874 date "2005-10-17" @default.
• W2033505874 modified "2023-10-15" @default.
• W2033505874 title "Long-term remission rates after pituitary surgery for Cushing's disease: the need for long-term surveillance" @default.
• W2033505874 cites W102056867 @default.
• W2033505874 cites W1482627741 @default.
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• W2033505874 cites W1966601507 @default.
• W2033505874 cites W1969851111 @default.
• W2033505874 cites W1991394376 @default.
• W2033505874 cites W1992503589 @default.
• W2033505874 cites W2000378947 @default.
• W2033505874 cites W2000607618 @default.
• W2033505874 cites W2001517162 @default.
• W2033505874 cites W2006589016 @default.
• W2033505874 cites W2014563951 @default.
• W2033505874 cites W2017027985 @default.
• W2033505874 cites W2018299169 @default.
• W2033505874 cites W2018790115 @default.
• W2033505874 cites W2018932366 @default.
• W2033505874 cites W2023551446 @default.
• W2033505874 cites W2026692182 @default.
• W2033505874 cites W2027091725 @default.
• W2033505874 cites W2032243333 @default.
• W2033505874 cites W2037661367 @default.
• W2033505874 cites W2040950362 @default.
• W2033505874 cites W2049680367 @default.
• W2033505874 cites W2053019230 @default.
• W2033505874 cites W2056581476 @default.
• W2033505874 cites W2063081075 @default.
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• W2033505874 cites W2073869734 @default.
• W2033505874 cites W2085758447 @default.
• W2033505874 cites W2089877536 @default.
• W2033505874 cites W2093110406 @default.
• W2033505874 cites W2101524020 @default.
• W2033505874 cites W2111820279 @default.
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• W2033505874 cites W2128526924 @default.
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• W2033505874 cites W2139056828 @default.
• W2033505874 cites W2144491498 @default.
• W2033505874 cites W2148602950 @default.
• W2033505874 cites W2148678921 @default.
• W2033505874 cites W2161622680 @default.
• W2033505874 cites W2165419265 @default.
• W2033505874 cites W2165662435 @default.
• W2033505874 cites W2168777999 @default.
• W2033505874 cites W2170983800 @default.
• W2033505874 cites W2253637595 @default.
• W2033505874 cites W2331609610 @default.
• W2033505874 cites W2418892212 @default.
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• W2033505874 doi "https://doi.org/10.1111/j.1365-2265.2005.02380.x" @default.
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