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  Favorable long-term outcomes of bilateral adrenalectomy in Cushing's disease

Owald, A., Plomer, E., Dimopoulou, C., Milian, M., Blaser, R., Ritzel, K., et al. (2014). Favorable long-term outcomes of bilateral adrenalectomy in Cushing's disease. EUROPEAN JOURNAL OF ENDOCRINOLOGY, 171(2), 209-215. doi:10.1530/EJE-14-0214.

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 Creators:
Owald, Andrea1, Author
Plomer, Eva1, Author
Dimopoulou, Christina2, Author           
Milian, Monika1, Author
Blaser, Rainer1, Author
Ritzel, Katrin1, Author
Mickisch, Anne1, Author
Knerr, Ferengis1, Author
Stanojevic, Milan1, Author
Hallfeldt, Klaus1, Author
Schopohl, Jochen1, Author
Kuhn, Klaus A.1, Author
Stalla, Günter2, Author           
Beuschlein, Felix1, Author
Reincke, Martin1, Author
Affiliations:
1external, ou_persistent22              
2Dept. Clinical Research, Max Planck Institute of Psychiatry, Max Planck Society, ou_2035296              

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 Abstract: Objective: Bilateral adrenalectomy (BADX) is an important treatment option for patients with Cushing's syndrome (CS). Our aim is to analyze the long-term outcomes, surgical, biochemical, and clinical as well as morbidity and mortality, of patients who underwent BADX. Design: A total of 50 patients who underwent BADX since 1990 in two German centers were identified. Of them, 34 patients had Cushing's disease (CD), nine ectopic CS (ECS), and seven ACTH-independent bilateral adrenal hyperplasia (BAH). Methods: Standardized follow-up examination was performed in 36 patients with a minimum follow-up time of 6 months after BADX and a median follow-up time of 11 years. Results: Surgical morbidity and mortality were 6 and 4% respectively. All patients were found to be in remission after BADX. Almost all Cushing's-specific comorbidities except for psychiatric diseases improved significantly. Health-related quality of life remained impaired in 45.0% of female and 16.7% of male patients compared with a healthy population. The median number of adrenal crises per 100 patient-years was four. Nelson tumor occurred in 24% of CD patients after a median time span of 51 months. Long-term mortality after 10 years was high in ECS (44%) compared with CD (3%) and BAH (14%). Conclusions: BADX is an effective and relatively safe treatment option especially in patients with CD. The majority of patients experience considerable improvement of Cushing's symptoms.

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Language(s): eng - English
 Dates: 2014-08
 Publication Status: Issued
 Pages: -
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 Table of Contents: -
 Rev. Type: -
 Identifiers: ISI: 000343670700012
DOI: 10.1530/EJE-14-0214
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Title: EUROPEAN JOURNAL OF ENDOCRINOLOGY
Source Genre: Journal
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Publ. Info: Bristol, UK : Bioscientifica Ltd.
Pages: - Volume / Issue: 171 (2) Sequence Number: - Start / End Page: 209 - 215 Identifier: ISSN: 0804-4643