Preoperative medical treatment in Cushing's syndrome: frequency of use and its impact on postoperative assessment: data from ERCUSYN

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00216208%3A11120%2F18%3A43916576" target="_blank" >RIV/00216208:11120/18:43916576 - isvavai.cz</a>

Alternative codes found

RIV/00064173:_____/18:N0000035

Result on the web

<a href="https://doi.org/10.1530/EJE-17-0997" target="_blank" >https://doi.org/10.1530/EJE-17-0997</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1530/EJE-17-0997" target="_blank" >10.1530/EJE-17-0997</a>

Result language

angličtina

Original language name

Preoperative medical treatment in Cushing's syndrome: frequency of use and its impact on postoperative assessment: data from ERCUSYN

Original language description

BACKGROUND: Surgery is the definitive treatment of Cushing&apos;s syndrome (CS) but medications may also be used as a first-line therapy. Whether preoperative medical treatment (PMT) affects postoperative outcome remains controversial.OBJECTIVE: (1) Evaluate how frequently PMT is given to CS patients across Europe; (2) examine differences in preoperative characteristics of patients who receive PMT and those who undergo primary surgery and (3) determine if PMT influences postoperative outcome in pituitary-dependent CS (PIT-CS).PATIENTS AND METHODS: 1143 CS patients entered into the ERCUSYN database from 57 centers in 26 countries. Sixty-nine percent had PIT-CS, 25% adrenal-dependent CS (ADR-CS), 5% CS from an ectopic source (ECT-CS) and 1% were classified as having CS from other causes (OTH-CS).RESULTS: Twenty per cent of patients took PMT. ECT-CS and PIT-CS were more likely to receive PMT compared to ADR-CS (P &lt; 0.001). Most commonly used drugs were ketoconazole (62%), metyrapone (16%) and a combination of both (12%). Median (interquartile range) duration of PMT was 109 (98) days. PIT-CS patients treated with PMT had more severe clinical features at diagnosis and poorer quality of life compared to those undergoing primary surgery (SX) (P &lt; 0.05). Within 7 days of surgery, PIT-CS patients treated with PMT were more likely to have normal cortisol (P &lt; 0.01) and a lower remission rate (P &lt; 0.01). Within 6 months of surgery, no differences in morbidity or remission rates were observed between SX and PMT groups.CONCLUSIONS: PMT may confound the interpretation of immediate postoperative outcome. Follow-up is recommended to definitely evaluate surgical results.

Czech name

—

Czech description

—

Type

J_imp - Article in a specialist periodical, which is included in the Web of Science database

CEP classification

—

OECD FORD branch

30202 - Endocrinology and metabolism (including diabetes, hormones)

Project

—

Continuities

N - Vyzkumna aktivita podporovana z neverejnych zdroju

Publication year

2018

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

European Journal of Endocrinology

ISSN

0804-4643

e-ISSN

—

Volume of the periodical

178

Issue of the periodical within the volume

4

Country of publishing house

GB - UNITED KINGDOM

Number of pages

11

Pages from-to

399-409

UT code for WoS article

000429079300013

EID of the result in the Scopus database

2-s2.0-85044620904