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...

Descripción completa

Detalles Bibliográficos
Autores: Araujo Castro, Marta, Parra Ramírez, Paola, Robles Lázaro, Cristina, García Centeno, Rogelio, Gracia Gimeno, Paola, Fernández Ladreda, Mariana Tomé, Sampedro Núñez, Miguel Antonio, Marazuela Azpiroz, Mónica, Escobar Morreale, Héctor F., Valderrabano, Pablo
Tipo de recurso: artículo
Fecha de publicación:2021
País:España
Institución:Universidad Autónoma de Madrid
Repositorio:Biblos-e Archivo. Repositorio Institucional de la UAM
Idioma:inglés
OAI Identifier:oai:repositorio.uam.es:10486/715113
Acceso en línea:http://hdl.handle.net/10486/715113
https://dx.doi.org/10.3390/jcm10235509
Access Level:acceso abierto
Palabra clave:adrenal incidentalomas
autonomous cortisol secretion
dexamethasone suppression test
non-functioning adrenal incidentalomas
Medicina
id ES_db94bf9a8b0390f06106926eb9de206d
oai_identifier_str oai:repositorio.uam.es:10486/715113
network_acronym_str ES
network_name_str España
repository_id_str
spelling Predictors of tumour growth and autonomous cortisol secretion development during follow-up in non-functioning adrenal incidentalomasAraujo Castro, MartaParra Ramírez, PaolaRobles Lázaro, CristinaGarcía Centeno, RogelioGracia Gimeno, PaolaFernández Ladreda, Mariana ToméSampedro Núñez, Miguel AntonioMarazuela Azpiroz, MónicaEscobar Morreale, Héctor F.Valderrabano, Pabloadrenal incidentalomasautonomous cortisol secretiondexamethasone suppression testnon-functioning adrenal incidentalomasMedicinaPurpose: 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 growthThis work was supported by SENDIMAD (BECA SENDIMAD de Ayuda a la Investigación en Endocrinología, Nutrición y Diabetes 2019); and IRYCIS (Convocatoria intramural de ayudas a proyectos de investigación de investigadores noveles, investigadores clínicos asociados y/o grupos emergentes del Hospital Universitario Ramón y Cajal 2019) grantsMDPIDepartamento de Medicina20212021-12-01research articlehttp://purl.org/coar/resource_type/c_2df8fbb1VoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10486/715113https://dx.doi.org/10.3390/jcm10235509reponame:Biblos-e Archivo. Repositorio Institucional de la UAMinstname:Universidad Autónoma de MadridInglésengopen accesshttp://purl.org/coar/access_right/c_abf2Attribution 4.0 Internationalhttp://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:repositorio.uam.es:10486/7151132026-06-23T12:46:27Z
dc.title.none.fl_str_mv 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
spellingShingle Predictors of tumour growth and autonomous cortisol secretion development during follow-up in non-functioning adrenal incidentalomas
Araujo Castro, Marta
adrenal incidentalomas
autonomous cortisol secretion
dexamethasone suppression test
non-functioning adrenal incidentalomas
Medicina
title_short 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_sort Predictors of tumour growth and autonomous cortisol secretion development during follow-up in non-functioning adrenal incidentalomas
dc.creator.none.fl_str_mv Araujo Castro, Marta
Parra Ramírez, Paola
Robles Lázaro, Cristina
García Centeno, Rogelio
Gracia Gimeno, Paola
Fernández Ladreda, Mariana Tomé
Sampedro Núñez, Miguel Antonio
Marazuela Azpiroz, Mónica
Escobar Morreale, Héctor F.
Valderrabano, Pablo
author Araujo Castro, Marta
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 Azpiroz, Mónica
Escobar Morreale, Héctor F.
Valderrabano, Pablo
author_role author
author2 Parra Ramírez, Paola
Robles Lázaro, Cristina
García Centeno, Rogelio
Gracia Gimeno, Paola
Fernández Ladreda, Mariana Tomé
Sampedro Núñez, Miguel Antonio
Marazuela Azpiroz, Mónica
Escobar Morreale, Héctor F.
Valderrabano, Pablo
author2_role author
author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Departamento de Medicina
dc.subject.none.fl_str_mv adrenal incidentalomas
autonomous cortisol secretion
dexamethasone suppression test
non-functioning adrenal incidentalomas
Medicina
topic adrenal incidentalomas
autonomous cortisol secretion
dexamethasone suppression test
non-functioning adrenal incidentalomas
Medicina
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
publishDate 2021
dc.date.none.fl_str_mv 2021
2021-12-01
dc.type.none.fl_str_mv research article
http://purl.org/coar/resource_type/c_2df8fbb1
VoR
http://purl.org/coar/version/c_970fb48d4fbd8a85
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv http://hdl.handle.net/10486/715113
https://dx.doi.org/10.3390/jcm10235509
url http://hdl.handle.net/10486/715113
https://dx.doi.org/10.3390/jcm10235509
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution 4.0 International
http://creativecommons.org/licenses/by/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution 4.0 International
http://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv MDPI
publisher.none.fl_str_mv MDPI
dc.source.none.fl_str_mv reponame:Biblos-e Archivo. Repositorio Institucional de la UAM
instname:Universidad Autónoma de Madrid
instname_str Universidad Autónoma de Madrid
reponame_str Biblos-e Archivo. Repositorio Institucional de la UAM
collection Biblos-e Archivo. Repositorio Institucional de la UAM
repository.name.fl_str_mv
repository.mail.fl_str_mv
_version_ 1869421689084837888
score 15,812429

Similares en LA Referencia