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Predictors of Tumour Growth and Autonomous Cortisol Secretion Development during Follow-Up in Non-Functioning Adrenal Incidentalomas

Purpose: To assess the risk of developing autonomous cortisol secretion (ACS) and tumour growth in non-functioning adrenal incidentalomas (NFAIs). Methods: Multicentre retrospective observational study of patients with NFAIs. ACS was defined as serum cortisol >1.8 µg/dL after 1 mg-dexamethasone s...

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Autores principales: Araujo-Castro, Marta, Parra Ramírez, Paola, Robles Lázaro, Cristina, García Centeno, Rogelio, Gracia Gimeno, Paola, Fernández-Ladreda, Mariana Tomé, Sampedro Núñez, Miguel Antonio, Marazuela, Mónica, Escobar-Morreale, Héctor F., Valderrabano, Pablo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8658279/
https://www.ncbi.nlm.nih.gov/pubmed/34884211
http://dx.doi.org/10.3390/jcm10235509
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author Araujo-Castro, Marta
Parra Ramírez, Paola
Robles Lázaro, Cristina
García Centeno, Rogelio
Gracia Gimeno, Paola
Fernández-Ladreda, Mariana Tomé
Sampedro Núñez, Miguel Antonio
Marazuela, Mónica
Escobar-Morreale, Héctor F.
Valderrabano, Pablo
author_facet Araujo-Castro, Marta
Parra Ramírez, Paola
Robles Lázaro, Cristina
García Centeno, Rogelio
Gracia Gimeno, Paola
Fernández-Ladreda, Mariana Tomé
Sampedro Núñez, Miguel Antonio
Marazuela, Mónica
Escobar-Morreale, Héctor F.
Valderrabano, Pablo
author_sort Araujo-Castro, Marta
collection PubMed
description Purpose: To assess the risk of developing autonomous cortisol secretion (ACS) and tumour growth in non-functioning adrenal incidentalomas (NFAIs). Methods: Multicentre retrospective observational study of patients with NFAIs. ACS was defined as serum cortisol >1.8 µg/dL after 1 mg-dexamethasone suppression test (DST) without specific data on Cushing’s syndrome. Tumour growth was defined as an increase in maximum tumour diameter >20% from baseline; and of at least 5 mm. Results: Of 654 subjects with NFAIs included in the study, both tumour diameter and DST were re-evaluated during a follow-up longer than 12 months in 305 patients. After a median follow-up of 41.3 (IQR 24.7–63.1) months, 10.5% of NFAIs developed ACS. The risk for developing ACS was higher in patients with higher serum cortisol post-DST levels (HR 6.45 for each µg/dL, p = 0.001) at diagnosis. Significant tumour growth was observed in 5.2% of cases. The risk of tumour growth was higher in females (HR 10.7, p = 0.004). Conclusions: The frequency of re-evaluation with DST in NFAIs during the initial 5 years from diagnosis can probably be tailored to the serum cortisol post-DST level at presentation. Re-evaluation of NFAIs with imaging studies, on the other hand, seems unnecessary in most cases, particularly if the initial imaging demonstrates features specific to typical adenoma, given the low rate of significant tumour growth.
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spelling pubmed-86582792021-12-10 Predictors of Tumour Growth and Autonomous Cortisol Secretion Development during Follow-Up in Non-Functioning Adrenal Incidentalomas Araujo-Castro, Marta Parra Ramírez, Paola Robles Lázaro, Cristina García Centeno, Rogelio Gracia Gimeno, Paola Fernández-Ladreda, Mariana Tomé Sampedro Núñez, Miguel Antonio Marazuela, Mónica Escobar-Morreale, Héctor F. Valderrabano, Pablo J Clin Med Article Purpose: To assess the risk of developing autonomous cortisol secretion (ACS) and tumour growth in non-functioning adrenal incidentalomas (NFAIs). Methods: Multicentre retrospective observational study of patients with NFAIs. ACS was defined as serum cortisol >1.8 µg/dL after 1 mg-dexamethasone suppression test (DST) without specific data on Cushing’s syndrome. Tumour growth was defined as an increase in maximum tumour diameter >20% from baseline; and of at least 5 mm. Results: Of 654 subjects with NFAIs included in the study, both tumour diameter and DST were re-evaluated during a follow-up longer than 12 months in 305 patients. After a median follow-up of 41.3 (IQR 24.7–63.1) months, 10.5% of NFAIs developed ACS. The risk for developing ACS was higher in patients with higher serum cortisol post-DST levels (HR 6.45 for each µg/dL, p = 0.001) at diagnosis. Significant tumour growth was observed in 5.2% of cases. The risk of tumour growth was higher in females (HR 10.7, p = 0.004). Conclusions: The frequency of re-evaluation with DST in NFAIs during the initial 5 years from diagnosis can probably be tailored to the serum cortisol post-DST level at presentation. Re-evaluation of NFAIs with imaging studies, on the other hand, seems unnecessary in most cases, particularly if the initial imaging demonstrates features specific to typical adenoma, given the low rate of significant tumour growth. MDPI 2021-11-25 /pmc/articles/PMC8658279/ /pubmed/34884211 http://dx.doi.org/10.3390/jcm10235509 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Araujo-Castro, Marta
Parra Ramírez, Paola
Robles Lázaro, Cristina
García Centeno, Rogelio
Gracia Gimeno, Paola
Fernández-Ladreda, Mariana Tomé
Sampedro Núñez, Miguel Antonio
Marazuela, Mónica
Escobar-Morreale, Héctor F.
Valderrabano, Pablo
Predictors of Tumour Growth and Autonomous Cortisol Secretion Development during Follow-Up in Non-Functioning Adrenal Incidentalomas
title Predictors of Tumour Growth and Autonomous Cortisol Secretion Development during Follow-Up in Non-Functioning Adrenal Incidentalomas
title_full Predictors of Tumour Growth and Autonomous Cortisol Secretion Development during Follow-Up in Non-Functioning Adrenal Incidentalomas
title_fullStr Predictors of Tumour Growth and Autonomous Cortisol Secretion Development during Follow-Up in Non-Functioning Adrenal Incidentalomas
title_full_unstemmed Predictors of Tumour Growth and Autonomous Cortisol Secretion Development during Follow-Up in Non-Functioning Adrenal Incidentalomas
title_short Predictors of Tumour Growth and Autonomous Cortisol Secretion Development during Follow-Up in Non-Functioning Adrenal Incidentalomas
title_sort predictors of tumour growth and autonomous cortisol secretion development during follow-up in non-functioning adrenal incidentalomas
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8658279/
https://www.ncbi.nlm.nih.gov/pubmed/34884211
http://dx.doi.org/10.3390/jcm10235509
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