Table 2.
Predictors for remission
| Predictors for remission | Studies |
|---|---|
| • Identification of the tumor pre-surgery by MRI | Bochicchio et al. 1995 [7], Chee et al. 2001 [21] |
| • No invasion of the sinus cavernosus by the adenoma | Cannavo et al. 2003 [116] |
| • Low postoperative cortisol levels (below normal ranges or not measurable, <2 µg/dL) | Bochicchio et al. 1995 [7], Liu et al. 2019 [25], Fleseriu et al. 2016 [34], Pieters et al.1989 [117], Lindsay et al. 2011 [118], Aranda et al. 2015 [119], Imaki et al. 2001 [120], Ironside et al. 2018 [121], Mayberg et al. 2018 [122] |
| • Low cortisol levels 6–12 weeks after surgery (<35 nmol/l) | Toms et al. 1993 [123] |
| • Long-term replacement therapy required (>1 year), long term of hypocortisolism (>1 year) | Bochicchio et al. 1995 [7], Bansal et al. 2017 [106] |
| • Low postoperative ACTH levels (mean 7.9 ng/L or mean 13 pg/ml, respectively), ACTH value <3.3 pmol/L postoperative | Liu et al. 2019 [25], Kuo et al. 2017 [26], Abellan-Galiana et al. 2019 [124] |
| • Histological confirmation of adenoma | Pouratian et al. 2007 [29], Serban et al. 2020 [125] |
| • Lower DHEA levels pre-surgery | Kuo et al. 2017 [26] |
| • Lower ACTH levels pre-surgery (mean = 71 ng/L) | Liu et al. 2019 [25], Kuo et al. 2017 [26], Selek et al. 2018 [126] |
| • Significant decrease of BMI post-surgery | Kuo et al. 2017 [26] |
| • Experience of the surgeon/the center | Barker et al. 2003 [20], Honegger et al. 2018 [55], Rees et al. 2002 [127], Serban et al. 2020 [125] |
| • Age (mean age 35 years; recurrence more often in younger age below 35 years) | Liu et al. 2019 [25] |
| • No USP8 mutant coricotroph tumor | Albani et al. 2018 [27] |
| • Short time to recovery from postoperative adrenal insufficiency | Berr et al. 2015 [28] |
| • Postoperative cortisol response to desmopressin (delta < 193 nmol/l), low cortisol and ACTH peak after desmopressin, response to desmopressin after 6 months | Romanholi et al. 2008 [128], Valero et al. 2004 [129], Vassiliadi et al.2016 [130], Losa et al. 2009 [131], L Marc’hadour et al. 2015 [132], Barbot et al. 2013 [133], Losa et al. 2001 [134], Cambos et al. 2020 [42] |
| • Post-surgery 11-deoxycortisol < 150 nmol/l after metyrapone-test | van Aken et al. 1997 [135] |
| • Cortisol < 49 nmol/L in a 48 h suppression test with betamethasone 2 mg/day | Uvelius et al. 2018 [136] |