Abstract | OBJECT: METHODS: One veterinary neurosurgeon performed transsphenoidal hypophysectomies in 181 dogs with PDH over a 12-year period. Survival analysis was performed with the Kaplan-Meier method. Prognostic factors were analyzed with the univariate Cox proportional hazard analysis followed by stepwise multivariate analysis. The log-rank test was used to assess disease-free fractions in three groups categorized according to early postoperative urinary corticoid/ creatinine (C/C) ratios. RESULTS: Multivariate analysis revealed that old age, large pituitary size, and high preoperative concentrations of plasma adrenocorticotropic hormone were associated with an increased risk of PDH-related death. In addition, large pituitary size, thick sphenoid bone, high C/C ratio, and high concentration of plasma alpha-melanocyte-stimulating hormone ( alpha-MSH) before surgery were associated with an increased risk of disease recurrence in the dogs that went into remission after hypophysectomy. Disease-free fractions were significantly higher in dogs with postoperative urinary C/C ratios in the lower normal range (< 5 x 10(-6)) than in dogs with postoperative C/C ratios in the upper normal range (5-10 x 10(-6)). CONCLUSIONS: The results of this study indicate that pituitary size, sphenoid bone thickness, plasma alpha-MSH concentration, and preoperative level of urinary cortisol excretion are predictors of long-term remission after transsphenoidal hypophysectomy for PDH in dogs. Urinary C/C ratios measured 6 to 10 weeks after surgery can be used as a guide for predicting the risk of tumor recurrence.
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Authors | Jeanette M Hanson, Erik Teske, George Voorhout, Sara Galac, Hans S Kooistra, Björn P Meij |
Journal | Journal of neurosurgery
(J Neurosurg)
Vol. 107
Issue 4
Pg. 830-40
(Oct 2007)
ISSN: 0022-3085 [Print] United States |
PMID | 17937231
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Topics |
- Adrenocortical Hyperfunction
(mortality, surgery, veterinary)
- Animals
- Dog Diseases
(mortality, surgery)
- Dogs
- Female
- Hypophysectomy
(mortality, veterinary)
- Male
- Neoplasm, Residual
(mortality)
- Pituitary ACTH Hypersecretion
(mortality, surgery, veterinary)
- Pituitary Gland
(surgery)
- Predictive Value of Tests
- Prognosis
- Proportional Hazards Models
- Recurrence
- Remission Induction
- Risk Factors
- Sphenoid Bone
(surgery)
- Survival Rate
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