CONTEXT: Data on mortality associated with Cushing's disease (CD) and Cushing's syndrome (CS) are scarce. OBJECTIVE: To perform a systematic review and meta-analysis of mortality studies in patients with CD and CS secondary to a benign adrenal adenoma. DATA SOURCES: A search was performed in seven electronic databases. Sixty-six articles were retrieved for analysis and 7 included in the final study. The main outcome measure was standardized mortality ratio (SMR). STUDY ELIGIBILITY CRITERIA, PARTICIPANTS, AND INTERVENTIONS: Studies reporting SMR for patients diagnosed with CD and/or CS. Outcomes were stratified by subtype of Cushing's syndrome. STUDY APPRAISAL AND SYNTHESIS METHODS: Studies were appraised by two authors and were synthesized using a weighted estimate based on the standard error of the SMR. RESULTS: The weighted mean of SMR for patients with CD was 1.84 (95% confidence interval (CI): 1.28-2.65). CD patients with persistent disease after initial surgery had a SMR of 3.73 (95% CI: 2.31-6.01), whereas mortality of CD patients with initial remission did not differ significantly from the general population (SMR: 1.23 (95% CI: 0.51-2.97)). SMR for patients with a benign adrenal adenoma was 1.90 (95% CI: 0.93-3.91). Age, sex and observation time did not significantly impact mortality. CONCLUSIONS: CD as opposed to CS due to a benign adrenal adenoma is associated with an excess mortality, which is attributed to patients in whom initial surgical cure is not obtained. This underlines the importance of a rigorous and early follow-up of newly operated patients with CD. Copyright Â
CONTEXT: Data on mortality associated with Cushing's disease (CD) and Cushing's syndrome (CS) are scarce. OBJECTIVE: To perform a systematic review and meta-analysis of mortality studies in patients with CD and CS secondary to a benign adrenal adenoma. DATA SOURCES: A search was performed in seven electronic databases. Sixty-six articles were retrieved for analysis and 7 included in the final study. The main outcome measure was standardized mortality ratio (SMR). STUDY ELIGIBILITY CRITERIA, PARTICIPANTS, AND INTERVENTIONS: Studies reporting SMR for patients diagnosed with CD and/or CS. Outcomes were stratified by subtype of Cushing's syndrome. STUDY APPRAISAL AND SYNTHESIS METHODS: Studies were appraised by two authors and were synthesized using a weighted estimate based on the standard error of the SMR. RESULTS: The weighted mean of SMR for patients with CD was 1.84 (95% confidence interval (CI): 1.28-2.65). CDpatients with persistent disease after initial surgery had a SMR of 3.73 (95% CI: 2.31-6.01), whereas mortality of CDpatients with initial remission did not differ significantly from the general population (SMR: 1.23 (95% CI: 0.51-2.97)). SMR for patients with a benign adrenal adenoma was 1.90 (95% CI: 0.93-3.91). Age, sex and observation time did not significantly impact mortality. CONCLUSIONS:CD as opposed to CS due to a benign adrenal adenoma is associated with an excess mortality, which is attributed to patients in whom initial surgical cure is not obtained. This underlines the importance of a rigorous and early follow-up of newly operated patients with CD. Copyright Â
Authors: Alexander D Sherry; Mohamed H Khattab; Mark C Xu; Patrick Kelly; Joshua L Anderson; Guozhen Luo; Andrea L Utz; Lola B Chambless; Anthony J Cmelak; Albert Attia Journal: Pituitary Date: 2019-12 Impact factor: 4.107
Authors: Mareike R Stieg; Matthias K Auer; Christina Berr; Julia Fazel; Martin Reincke; Stephanie Zopp; Alexander Yassouridis; Günter K Stalla Journal: Pituitary Date: 2019-04 Impact factor: 4.107
Authors: A L Serban; G Del Sindaco; E Sala; G Carosi; R Indirli; G Rodari; C Giavoli; M Locatelli; G Carrabba; G Bertani; G Marfia; G Mantovani; M Arosio; E Ferrante Journal: J Endocrinol Invest Date: 2019-11-26 Impact factor: 4.256