Repeated transsphenoidal surgery or gamma knife radiosurgery in recurrent cushing disease after transsphenoidal surgery.

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.

• Authors: Mohammad Bodaghabadi, Hooman Riazi, Shima Aran, Mohammad Ali Bitaraf, Mazdak Alikhani, Mahmud Alahverdi, Masoumeh Mohamadi, Keivan Shalileh, Maziar Azar
• Journal: Journal of neurological surgery. Part A, Central European neurosurgery (J Neurol Surg A Cent Eur Neurosurg) Vol. 75 Issue 2 Pg. 91-7 (Mar 2014) ISSN: 2193-6323 [Electronic] Germany
• PMID: 23965751 (Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial)
• Copyright: Georg Thieme Verlag KG Stuttgart · New York.

Topics

• Adenoma (pathology, surgery)
• Adolescent
• Adult
• Female
• Humans
• Male
• Middle Aged
• Pituitary ACTH Hypersecretion (pathology, surgery)
• Pituitary Neoplasms (pathology, surgery)
• Radiosurgery
• Recurrence
• Reoperation
• Retrospective Studies
• Sphenoid Bone (surgery)
• Treatment Outcome
• Young Adult