TY - JOUR T1 - Presurgical predictive factors of surgical remission in Cushing's disease. Study of 32 cases JO - Endocrinología, Diabetes y Nutrición T2 - AU - Araujo-Castro,Marta AU - Marchán Pinedo,Marta AU - Fernández-Argüeso,María AU - Pérez Pérez,María AU - Barrero Ruíz,Estrella AU - Pian,Héctor AU - Rodríguez Berrocal,Víctor AU - Pascual-Corrales,Eider SN - 25300164 M3 - 10.1016/j.endinu.2021.07.004 DO - 10.1016/j.endinu.2021.07.004 UR - https://www.elsevier.es/es-revista-endocrinologia-diabetes-nutricion-13-articulo-presurgical-predictive-factors-surgical-remission-S2530016421001919 AB - PurposeIdentify presurgical factors associated with surgical remission in Cushing's disease (CD). MethodsAll the patients with ACTH-dependent Cushing's Syndrome in follow-up at our centre between 2014–2021 (n=40) were identified. Those patients with CD diagnosis who underwent transsphenoidal surgery by the same neurosurgeon (n=32) were included. Surgical remission was defined as plasma cortisol <1.8μg/dl and normal or low urinary free cortisol (UFC) after surgery. ResultsSixty-three per cent (n=20) were women, and the mean age at diagnosis was 42.3±17.9 years. Six patients had macroadenomas, 17 had microadenomas, and in the other 9 patients, no pituitary lesion was identified on the MRI. Seven patients were previously operated on in another centre. Surgical remission was achieved in 75% (n=24). Only three patients experienced recurrence. No association between pre-surgical demographic (age, sex, comorbidities) or hormonal (UFC, ACTH, late-night salivary cortisol levels) characteristics and the probability of surgical remission was observed. The only variable associated with a greater chance of remission was the presurgical visualisation of the adenoma on MRI (OR 8.3, P=0.02). It was also observed that patients with a history of a previous pituitary surgery had a lower tendency to achieve remission, although statistical significance was not reached (OR 0.17, P=0.09). ConclusionsIn our experience, 75% of patients with CD achieved biochemical cure after the intervention. Surgical remission was up to eight times more frequent in those patients in whom the adenoma was visualised before the intervention, but no other presurgical predictive factors of cure were identified. ER -