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Multiple hormone se...
Multiple hormone secretion may indicate worse prognosis in patients with ectopic Cushing's syndrome
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- Lase, Ieva (författare)
- Uppsala universitet,Onkologisk endokrinologi
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- Strele, Ieva (författare)
- Riga Stradins Univ, Dept Publ Hlth & Epidemiol, Dzirciema St 16, LV-1007 Riga, Latvia
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- Grönberg, Malin, 1980- (författare)
- Uppsala universitet,Onkologisk endokrinologi
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- Kozlovacki, Gordana (författare)
- Uppsala universitet,Onkologisk endokrinologi
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- Welin, Staffan (författare)
- Uppsala universitet,Onkologisk endokrinologi
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- Tiensuu Janson, Eva (författare)
- Uppsala universitet,Onkologisk endokrinologi
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(creator_code:org_t)
- 2020-01-16
- 2020
- Engelska.
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Ingår i: Hormones. - : Springer Science and Business Media LLC. - 1109-3099 .- 2520-8721. ; 19:3, s. 351-360
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Abstract
Ämnesord
Stäng
- PurposeEctopic Cushing’s syndrome (ECS) caused by an ACTH secreting neuroendocrine neoplasm (NEN) is a rare and challenging condition. We aimed to detect predictive and prognostic parameters for ECS patients identified from a retrospective, comprehensive cohort of NENs treated at a tertiary referral center.MethodsMedical records of 886 patients with NENs were reviewed. We identified 51 patients with ECS (33 females/18 men); mean age 52 ± 15 years (SD). Clinical parameters including symptoms, biochemical markers, and survival were extracted and further analyzed.ResultsThe primary tumor was located in the thorax (n = 28) or pancreas (n = 15) or was of unknown primary origin (n = 8). In 30 patients, tumor and ECS were diagnosed simultaneously. In 12 patients, the NEN diagnosis preceded ECS development, with a median time of 43.5 months (range: 9–96), and 10 of these showed radiological tumor progression at ECS diagnosis. Twenty-one patients had multiple hormone secretion, which correlated with shorter overall survival (OS), p = 0.012 (HR 2.4 (95% CI 1.2–4.9)), as did high morning cortisol, p = 0.037 (HR 2.3 (1.0–5.2)), higher tumor grade, p = 0.044 (HR 2.3 (1.0–5.1)), and diabetes, p = 0.050 (HR 2.4 (1.0–6.0)).ConclusionsMultiple hormone secretion, high morning cortisol, higher tumor grade, and diabetes were correlated with shorter OS. Development of ECS in patients with a non-functioning NEN may indicate tumor progression. Multiple hormone secretion should be considered as a bad prognostic sign in ECS patients and should lead to intensified clinical management.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Endokrinologi och diabetes (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Endocrinology and Diabetes (hsv//eng)
Nyckelord
- Ectopic Cushing's syndrome
- ACTH
- Neuroendocrine
- Hypercortisolism
- Multiple hormone secretion
- Hypokalemia
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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