Recurrent Cushing Disease: An Extensive Review on Pros and Cons of Different Therapeutic Approaches

Recurrent Cushing Disease: An Extensive Review on Pros and Cons of Different Therapeutic Approaches Publisher Pubmed

Sabahi M¹ ; Ghaseminesari P^{2, 3} ; Maroufi SF^{3, 4} ; Shahbazi T^{2, 3} ; Yousefi O⁵ ; Shahtaheri SA^{2, 3} ; Binalamer O¹ ; Dabecco R⁶ ; Velasquez N⁷ ; Arce KM⁸ ; Adada B⁶ ; Benjamin CG⁹ ; Borgheirazavi H⁶

Show Affiliations

1. Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, PA, United States
2. Neurosurgery Research Group (NRG), Student Research Committee, Hamadan University of Medical Sciences, Hamadan, Iran
3. Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
4. Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
5. Trauma Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
6. Department of Neurological Surgery, Pauline Braathen Neurological Centre, Cleveland Clinic Florida, Weston, FL, United States
7. Department of Otolaryngology/Head and Neck Surgery, Cleveland Clinic Florida, Weston, FL, United States
8. Department of Endocrinology, Diabetes and Metabolism, Cleveland Clinic Florida, Weston, FL, United States
9. Department of Neurosurgery, University of Miami, Miami, FL, United States

Source: World Neurosurgery Published:2023

Abstract

Objective: Recurrent Cushing disease (CD) is characterized by the reappearance of clinical and hormonal aspects of hypercortisolism that occur more than 6 months after an initial post-treatment remission. Methods: We performed a systematic review and meta-analysis to synthesize the evidence about remission and complication rates after transsphenoidal surgery (TSS) radiotherapy (RT) and medical therapy (MT) in recurrent CD patients. A quantitative systematic review was performed. Article selection was performed by searching MEDLINE (using PubMed), and Cochrane electronic bibliographic databases through 2020. Results: We noted 61 articles described therapeutic management of recurrent CD patients with representative outcome. A total of 723 patients received different therapeutic modality for their recurrent CD. The remission rates were 0.65 (95% confidence interval [CI] 0.60–0.70), 0.57 (95% CI 0.51–0.63), and 0.75 (95% CI 0.60–0.86) in the TSS, RT, and MT subgroups, respectively. The total remission rate after therapeutic approaches on recurrent CD patients was 0.64 (95% CI 0.60–0.68). A test for subgroup differences revealed there was a statistically significant difference between different subgroups (P = 0.01). The post hoc test showed that in comparison with RT, TSS (P = 0.0344) and MT (P = 0.0149) had a higher rate of remission. However, there was no statistically significant difference between separate therapeutic modalities in terms of complications including diabetes insipidus (P = 1.0) and hypopituitarism (P = 0.28). Conclusions: Compared MT and TSS, RT has a statistically lower rate of remission. Although there is robust superiority of surgery over RT, interpretation of MT data must considered with caution due to the small number of included cases and wide CI range. © 2023 Elsevier Inc.

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Style	Citing Format
MLA	Sabahi M, et al.. "Recurrent Cushing Disease: An Extensive Review on Pros and Cons of Different Therapeutic Approaches." World Neurosurgery, vol. 172, no. , 2023, pp. 49-65.
APA	Sabahi M, Ghaseminesari P, Maroufi SF, Shahbazi T, Yousefi O, Shahtaheri SA, Binalamer O, Dabecco R, Velasquez N, Arce KM, Adada B, Benjamin CG, Borgheirazavi H (2023). Recurrent Cushing Disease: An Extensive Review on Pros and Cons of Different Therapeutic Approaches. World Neurosurgery, 172(), 49-65.
Chicago	Sabahi M, Ghaseminesari P, Maroufi SF, Shahbazi T, Yousefi O, Shahtaheri SA, Binalamer O, et al.. "Recurrent Cushing Disease: An Extensive Review on Pros and Cons of Different Therapeutic Approaches." World Neurosurgery 172, no. (2023): 49-65.
Harvard	Sabahi M et al. (2023) 'Recurrent Cushing Disease: An Extensive Review on Pros and Cons of Different Therapeutic Approaches', World Neurosurgery, 172(), pp. 49-65.
Vancouver	Sabahi M, Ghaseminesari P, Maroufi SF, Shahbazi T, Yousefi O, Shahtaheri SA, et al.. Recurrent Cushing Disease: An Extensive Review on Pros and Cons of Different Therapeutic Approaches. World Neurosurgery. 2023;172():49-65.
BibTex	@article{ author = {Sabahi M and Ghaseminesari P and Maroufi SF and Shahbazi T and Yousefi O and Shahtaheri SA and Binalamer O and Dabecco R and Velasquez N and Arce KM and Adada B and Benjamin CG and Borgheirazavi H}, title = {Recurrent Cushing Disease: An Extensive Review on Pros and Cons of Different Therapeutic Approaches}, journal = {World Neurosurgery}, volume = {172}, number = {}, pages = {49-65}, year = {2023} }
RIS	TY - JOUR AU - Sabahi M AU - Ghaseminesari P AU - Maroufi SF AU - Shahbazi T AU - Yousefi O AU - Shahtaheri SA AU - Binalamer O AU - Dabecco R AU - Velasquez N AU - Arce KM AU - Adada B AU - Benjamin CG AU - Borgheirazavi H TI - Recurrent Cushing Disease: An Extensive Review on Pros and Cons of Different Therapeutic Approaches JO - World Neurosurgery VL - 172 IS - SP - 49 EP - 65 PY - 2023 ER -

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