SynthesisPituitary2020
Outcomes of pituitary surgery for Cushing's disease: a systematic review and meta-analysis.
Synthesis in Pituitary, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 53 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
53 citing papers in PubMed, 4 syntheses or guidelines pooled it, 92 citations in OpenAlex.
- Predictors of long-term remission following trans-sphenoidal surgery in cushing's disease: a systematic review and meta-analysis based on different remission criteria.Neurosurgical review · 2026Pooled it
- Indocyanine green fluorescence in endoscopic transsphenoidal resection of pituitary neuroendocrine tumors: a systematic review.Acta neurochirurgica · 2025Pooled it
- The Effect of Endogenous Cushing Syndrome on All-cause and Cause-specific Mortality.The Journal of clinical endocrinology and metabolism · 2022Pooled it
- The clinical outcomes of imaging modalities for surgical management Cushing's disease - A systematic review and meta-analysis.Frontiers in endocrinology · 2022Pooled it
- Prospective Multicenter Evaluation of [Journal of nuclear medicine : official publication, Society of Nuclear Medicine · 2025Trial
- Hydrogel-based lineage-specific gene therapy prevents recurrence of corticotroph tumors.Molecular therapy. Oncology · 2026Article
- Racial and ethnic differences in presentation and postoperative recovery after transsphenoidal surgery for cushing disease.Journal of neuro-oncology · 2026Article
- The Potential Role of SGLT2 Inhibitors in Cushing's Disease.Diabetes, obesity & metabolism · 2026Review
- Is Hypercortisolism Treatable? Which Patients Should Be Treated and How-A Practical Guide for Clinicians.Diabetes, obesity & metabolism · 2026Review
- Update and Practical Recommendations for the Use of Medical Treatment of Cushing Syndrome.Endocrine reviews · 2026Review
- Management of persistent and recurrent Cushing's disease: Efficacy of repeat transsphenoidal surgery.Endocrine · 2026Article
- Impact of granulation pattern on surgical and long-term outcomes in Cushing's disease: a comparative study of DGCT and SGCT.Pituitary · 2026Article
- Very Long-Term Follow-Up of Multidimensional Health-Related Quality of Life After Endoscopic Endonasal Surgery for Pituitary Adenomas: A Prospective Cohort Study.Head & neck · 2026Article
- Risk of recurrence after successful surgery for Cushing's disease and association with USP8 genotype and tumour size: an international, retrospective, longitudinal cohort study.The lancet. Diabetes & endocrinology · 2026Article
- Prevalence and clinical relevance of negative histology after transsphenoidal surgery for pituitary neuroendocrine tumors.Frontiers in endocrinology · 2026Article
- Differential expression of POMC-processing genes in corticotroph tumors.Endocrine oncology (Bristol, England) · 2026Article
- Beyond the MRI-positive/MRI-negative dichotomy: A stepwise surgical strategy for Cushing's disease.Brain & spine · 2026Article
- A bibliometric analysis of Cushing's disease and magnetic resonance imaging: history, research hotspots, and emerging trends.Quantitative imaging in medicine and surgery · 2025Article
- Article
- The CuPeR model: A dynamic online tool for predicting Cushing's disease persistence and recurrence after pituitary surgery.Journal of clinical & translational endocrinology · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 5 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTranssphenoidal surgery (TSS) is the first-line treatment for Cushing's disease (CD). This review aimed to synthesize the remission and recurrence rates following TSS for CD and identify predictors of these outcomes.
methodsMedline (1946-) and Embase (1947-) were searched until 23rd January 2019 for original studies. A meta-analysis was performed of remission and recurrence rates. Studies were excluded if patients had prior radiosurgery/radiotherapy, mixed pathologies or interventions without separated data, follow-up not reported or population size < 20. For recurrence rate syntheses, studies with follow-up < 6 months were excluded.
resultsThe search produced 2663 studies, of which n = 68 were included, involving 5664 patients. Remission rates after primary and revision TSS were 80% [77-82] and 58% [50-66] at last follow-up. After primary TSS, predictors of remission were micro- v macroadenomas (83% v 68%, p < 0.01), imaging-visible adenomas (81% v 69%, p < 0.01), adenomas confirmed on histopathology (87% v 45%, p < 0.01), absence of cavernous sinus invasion (80% v 30%, p < 0.01), postoperative serum cortisol (MSeC) nadir < 2 μg/dL (< 55 nmol/L; 95% v 46%, p < 0.01) and lower preoperative 24-h urine free cortisol (1250 nmol v 1726 nmol, p < 0.01). For revision TSS, predictors of remission were postoperative MSeC nadir < 2 μg/dL (< 55 nmol/L; 100% v 38%, p < 0.01) and operations for recurrence v persistence (80% v 54%, p < 0.01). Recurrence rates after primary and revision TSS were 18% [14-22] and 28% [16-42].
conclusionsTSS is most effective in primary microadenomas, visible on preoperative imaging and without CS invasion, lower preoperative 24-h urine free cortisol and postoperative MSeC nadir < 2 μg/dL (< 55 nmol/L).
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.