Mohammad Bodaghabadi1, Hooman Riazi2, Shima Aran3, Mohammad Ali Bitaraf1, Mazdak Alikhani4, Mahmud Alahverdi5, Masoumeh Mohamadi6, Keivan Shalileh7, Maziar Azar4. 1. Department of Neuroradiosurgery, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran. 2. Department of Neurosurgery, Tehran University of Medical Sciences, Imam Khomeini Hospital, Tehran, Islamic Republic of Iran. 3. Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States. 4. Department of Neuroradiosurgery, Iran Gamma Knife Center, Tehran, Islamic Republic of Iran. 5. Department of Medical Physics and Biomedical Engineering, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran. 6. Department of Neuroradiosurgery, Tehran University of Medical Sciences, Imam Khomeini Hospital, Tehran, Islamic Republic of Iran. 7. Department of Radiology, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran.
Abstract
BACKGROUND: This study compared Gamma knife radiosurgery (GKRS) and repeated transsphenoidal adenomectomy (TSA) to find the best approach for recurrence of Cushing disease (CD) after unsuccessful first TSA. MATERIAL AND METHODS:Fifty-two patients with relapse of CD after TSA were enrolled and randomly underwent a second surgery or GKRS as the next therapeutic approach. They were followed for a mean period of 3.05 ± 0.8 years by physical examination and hormone measurement as well as magnetic resonance imaging. RESULTS: No significant difference was observed in sex ratio, mean age, adenoma type, follow-up duration, and initial hormone level between the two groups. No significant relationship was found between preoperative 24-hour free urine cortisol and disease-free months or tumor volume among both groups. Our statistical analysis showed higher recurrence-free interval in the GKRS group compared with TSA group. CONCLUSION: With longer recurrence-free interval, GKRS could be considered a good treatment alternative to repeated TSA in recurrent CD. Georg Thieme Verlag KG Stuttgart · New York.
RCT Entities:
BACKGROUND: This study compared Gamma knife radiosurgery (GKRS) and repeated transsphenoidal adenomectomy (TSA) to find the best approach for recurrence of Cushing disease (CD) after unsuccessful first TSA. MATERIAL AND METHODS: Fifty-two patients with relapse of CD after TSA were enrolled and randomly underwent a second surgery or GKRS as the next therapeutic approach. They were followed for a mean period of 3.05 ± 0.8 years by physical examination and hormone measurement as well as magnetic resonance imaging. RESULTS: No significant difference was observed in sex ratio, mean age, adenoma type, follow-up duration, and initial hormone level between the two groups. No significant relationship was found between preoperative 24-hour free urine cortisol and disease-free months or tumor volume among both groups. Our statistical analysis showed higher recurrence-free interval in the GKRS group compared with TSA group. CONCLUSION: With longer recurrence-free interval, GKRS could be considered a good treatment alternative to repeated TSA in recurrent CD. Georg Thieme Verlag KG Stuttgart · New York.
Authors: Carlos Perez-Vega; Andres Ramos-Fresnedo; Shashwat Tripathi; Ricardo A Domingo; Krishnan Ravindran; Joao P Almeida; Jennifer Peterson; Daniel M Trifiletti; Kaisorn L Chaichana; Alfredo Quinones-Hinojosa; Susan L Samson Journal: Pituitary Date: 2022-05-04 Impact factor: 4.107