ECE2014 Poster Presentations Adrenal cortex (56 abstracts)
Favorable long-term outcome of bilateral adrenalectomy in Cushing's disease
Andrea Osswald 1 , Eva Plomer 1 , Christina Dimopoulou 1, , Monika Milian 3 , Rainer Blaser 4 , Katrin Ritzel 1 , Anne Mickisch 1 , Ferengis Knerr 1 , Milan Stanojevic 3 , Klaus Hallfeldt 5 , Jochen Schopohl 1 , Klaus A Kuhn 4 , Günter Stalla 2 , Felix Beuschlein 1 & Martin Reincke 1
1Medizinische Klinik und Poliklinik IV, Ludwig-Maximilians-Universität München, München, Germany; 2Max-Planck-Institut für Psychiatrie, München, Germany; 3Department of Neurosurgery, University Hospital Tuebingen, Tübingen, Germany; 4IMSE, Klinikum rechts der Isar der TU München, München, Germany; 5Chirurgische Klinik und Poliklinik - Innenstadt, Klinikum der Ludwig-Maximilians-Universität München, München, Germany.
Objective: Bilateral adrenalectomy (BADX) is an important treatment option for patients with Cushing’s syndrome (CS). The outcome of this procedure has not been studied well.
The aim was to analyze long-term outcome of CS patients treated with BADX.
Design: Fifty patients with BADX treated since 1990 in two German centers were identified. 34 patients had Cushing’s disease (CD), nine ectopic Cushing-syndrome (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 after BADX of 6 months and a median follow-up time of 11 years. Surgical, biochemical and clinical outcome as well as morbidity and mortality were studied.
Results: Surgical morbidity and mortality were 6 and 4%, respectively. All patients went in remission after BADX. Nearly all Cushing’s specific comorbidities except for psychiatric diseases improved significantly. Health related quality of life remained impaired in 45.0% of the female and 16.7% of the male patients compared to healthy population. 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 to 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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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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