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Long-Term Outcome of Bilateral Laparoscopic Adrenalectomy Measured by Disease-Specific Questionnaire in a Unique Group of Patients with Cushing’s Syndrome

  • Endocrine Tumors
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Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Laparoscopic bilateral adrenalectomy (LBA) is recommended for patients with bilateral adrenal disease and occult or unresectable ectopic Cushing’s syndrome (CS). There are limited data on long-term outcomes after LBA, partly due to the lack of disease-specific tools for the measurement of impact on patients’ health and quality of life.

Methods

We used a disease-specific questionnaire covering all major clinicopathologic characteristics of CS. We compared the outcome from LBA to a control group of 60 patients who had thyroidectomy (matched for age, gender, and time of surgery, 2:1 control-to-CS).

Results

Twenty-eight patients (20 women and 8 men) underwent LBA for CS. Of them, 24 patients (86 %) provided responses to our questionnaire. Ninety-two percent of patients’ responses indicated a significant improvement of general Cushing’s physical features with complete resolution reported in 59 % of responses. Significant improvement of associated biochemical abnormalities and comorbidities was reported in 83 % of patients’ responses including complete reversal in 58 %. Significant improvement in emotional-behavioral symptoms was reported in 84 % of patients’ responses with complete recovery in 53 %. All patients expressed satisfaction with LBA and significant improvement in their general health and self-reported quality of life. All of the improvements after LBA were statistically significant compared with the control group.

Conclusions

Our disease-specific questionnaire enables a clearer understanding of the association between the clinical, metabolic, and emotional-behavioral features of CS, its treatment with LBA, and long-term impact on patient-reported quality of life. This disease-specific questionnaire may be useful for future studies in patients with CS.

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Acknowledgment

The study was supported by the NIH clinical protocols NCT00005927, NCT01005654, and NCT02001051.

Conflict of interest

Authors have no conflict of interest to declare.

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Authors and Affiliations

  1. Endocrine Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA

    Vladimir Neychev MD, PhD, Lily Yang BS, Amit Mehta MS III, Naris Nilubol MD, FCAS & Electron Kebebew MD, FACS

  2. Biostatistics and Data Management Section, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA

    Seth M. Steinberg PhD

  3. Section on Endocrinology and Genetics, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA

    Margaret F. Keil CRNP & Constantine A. Stratakis MD, DMSci

  4. Section on Reproductive Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA

    Lynnette Nieman MD

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  1. Vladimir Neychev MD, PhD
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Correspondence to Vladimir Neychev MD, PhD.

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Neychev, V., Steinberg, S.M., Yang, L. et al. Long-Term Outcome of Bilateral Laparoscopic Adrenalectomy Measured by Disease-Specific Questionnaire in a Unique Group of Patients with Cushing’s Syndrome. Ann Surg Oncol 22 (Suppl 3), 699–706 (2015). https://doi.org/10.1245/s10434-015-4605-1

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