Long-term mortality after transsphenoidal surgery for Cushing disease

Background: Untreated Gushing disease historically has a high mortality rat e, but the long-term survival of patients with Gushing disease after transs phenoidal surgery has not been reported. Objective: To determine long-term mortality rate in patients who are treate d for Gushing disease with current management techniques. Design: Retrospective case series. Setting: Tertiary care center. Patients: 161 patients (32 men and 129 women; mean age, 38 years) who were treated for Gushing disease between 1978 and 1996. Intervention: Transsphenoidal adenomectomy and as-needed adjunctive therapy . Measurement: Record review with follow-up interview. Results: The cure rate for patients with microadenomas who had no previous therapy was 90% (123 of 137). No perioperative deaths occurred (0 of 193 pr ocedures [95% CI, 0.0% to 1.9%]). Follow-up data (mean, 8.7 years) were obt ained for 99% of patients (159 of 161). Six patients died. The 5- and 10-ye ar survival rates were 99% (CI, 97% to 100%) and 93% (CI, 88% to 99%), resp ectively. Survival was similar to that seen in an age- and sex-matched samp le that was based on U.S. population data (standardized mortality ratio, 0. 98 [CI, 0.44 to 2.2]; P > 0.2). Conclusion: Survival of patients treated for Gushing disease with current m anagement techniques between 1978 and 1996 was better than the poor surviva l historically associated with this disorder.