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Título:
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Predictors of biochemical remission and recurrence after surgical and radiation treatments of cushing disease: a systematic review and meta-analysis
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Autores:
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Abu Dabrh, Abd Moain ;
Ospina, Naykky M. Singh ;
Al Nofal, Alaa ;
Farah, Wigdan H. ;
Barrionuevo, Patricia ;
Sarigianni, Maria ;
Mohabbat, Arya B. ;
Benkhadra, Khalid ;
Leon, Barbara G. Carranza ;
Gionfriddo, Michael R. ;
Wang, Zhen ;
Mohammed, Khaled ;
Ahmed, Ahmed T. ;
Elraiyah, Tarig A. ;
Haydour, Qusay ;
Alahdab, Fares ;
Prokop, Larry J. ;
Murad, Mohammad Hassan
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Tipo de documento:
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texto impreso
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Editorial:
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Asociación Americana de Endocrinólogos Clínicos, 2019-02-22T14:56:08Z
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Nota general:
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info:eu-repo/semantics/restrictedAccess
https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
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Idiomas:
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Inglés
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Palabras clave:
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Editados por otras instituciones
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Artículos
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Artículos en revistas indizadas
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Resumen:
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Objective: We conducted a systematic review and meta-analysis to synthesize the evidence about predictors that may affect biochemical remission and recurrence after transsphenoidal surgery (TSS), radiosurgery (RS), and radiotherapy (RT) in Cushing disease. Methods: We searched multiple databases through December 2014 including original controlled and uncontrolled studies that enrolled patients with Cushing disease who received TSS (first-line), RS, or RT. We extracted data independently, in duplicates. Outcomes of interest were biochemical remission and recurrence. A meta-analysis was conducted using the random-effects model to estimate event rates with 95% confidence intervals (CIs). Results: First-line TSS was associated with high remission (76% [95% CI, 72 to 79%]) and low recurrence rates (10% [95% CI, 6 to 16%]). Remission after TSS was higher in patients with microadenomas or positive-adrenocorticotropic hormone tumor histology. RT was associated with a high remission rate (RS, 68% [95% CI, 61 to 77%]; RT, 66% [95% CI, 58 to 75%]) but also with a high recurrence rate (RS, 32% [95% CI, 16 to 60%]; RT, 26% [95% CI, 14 to 48%]). Remission after RS was higher at short-term follow-up (
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En línea:
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http://doi.org/10.4158/EP15922.RA
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