Postoperative Serum Cortisol and Cushing Disease Recurrence in Patients With Corticotroph Adenomas
Authors' conclusion
Postoperative nadir serum cortisol is the most important cortisol variable associated with recurrence and time-to-recurrence. Compared to first postoperative cortisol and cortisol halving time, a nadir < 2 µg/dL showed the strongest association with long-term remission and typically occurs within the first 24 to 48 hours after surgery.
Study context
- Population
- Patients with CD and pathology-confirmed corticotroph adenoma after adenoma removal26 recurred
- Participants
- 320 patients
- Exposure
- Postoperative serum cortisol variables and CD recurrence
- Outcome
- Recurrence and time-to-recurrence by postoperative cortisol variables
Main finding
As reported in the abstract
Recurrence · median follow-up 25 months (95% CI, 19-28 months)
Hazard ratio (CI)P value
First postoperative cortisol ≥ 50 µg/dLvs First postoperative cortisol < 50 µg/dL
4.1(1.8–9.2)
P = 0.0003Halving timenot associated with recurrence
1.7(0.8–3.8)
P = 0.18Nadir cortisol ≥2 µg/dLvs Nadir cortisol < 2 µg/dL
6.6(2.6–16.6)
P < 0.0001Observational data: associations, not effects.
Original publication
Postoperative Serum Cortisol and Cushing Disease Recurrence in Patients With Corticotroph Adenomas. J Clin Endocrinol Metab. Published 8 June 2023. doi:10.
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