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lüll Long-term mortality after transsphenoidal surgery for Cushing disease Swearingen B; Biller BM; Barker FG 2nd; Katznelson L; Grinspoon S; Klibanski A; Zervas NTAnn Intern Med 1999[May]; 130 (10): 821-4BACKGROUND: Untreated Cushing disease historically has a high mortality rate, but the long-term survival of patients with Cushing disease after transsphenoidal surgery has not been reported. OBJECTIVE: To determine long-term mortality rate in patients who are treated for Cushing disease with current management techniques. DESIGN: Retrospective case series. SETTING: Tertiary care center. PATIENTS: 161 patients (32 men and 129 women; mean age, 38 years) who were treated for Cushing disease between 1978 and 1996. INTERVENTION: Transsphenoidal adenomectomy and as-needed adjunctive therapy. MEASUREMENT: Record review with follow-up interview. RESULTS: The cure rate for patients with microadenomas who had no previous therapy was 90% (123 of 137). No perioperative deaths occurred (0 of 193 procedures [95% CI, 0.0% to 1.9%]). Follow-up data (mean, 8.7 years) were obtained for 99% of patients (159 of 161). Six patients died. The 5- and 10-year survival rates were 99% (CI, 97% to 100%) and 93% (CI, 88% to 99%), respectively. Survival was similar to that seen in an age- and sex-matched sample that was based on U.S. population data (standardized mortality ratio, 0.98 [CI, 0.44 to 2.2]; P > 0.2). CONCLUSION: Survival of patients treated for Cushing disease with current management techniques between 1978 and 1996 was better than the poor survival historically associated with this disorder.|Adenoma/complications/metabolism/*surgery[MESH]|Adolescent[MESH]|Adrenal Gland Neoplasms/complications/metabolism/*surgery[MESH]|Adult[MESH]|Aged[MESH]|Child[MESH]|Cushing Syndrome/etiology/*mortality/*surgery[MESH]|Female[MESH]|Follow-Up Studies[MESH]|Humans[MESH]|Hydrocortisone/blood[MESH]|Male[MESH]|Matched-Pair Analysis[MESH]|Middle Aged[MESH]|Recurrence[MESH]|Retrospective Studies[MESH]|Statistics as Topic[MESH]|Survival Rate[MESH]|Time Factors[MESH] |