Observational studyInternal medicine (Tokyo, Japan)2025
Predictor of Steroid Replacement Duration after Removal of Cortisol-producing Adenoma.
Observational study in Internal medicine (Tokyo, Japan), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
What it found
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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.
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Who cites it
4 citing papers in PubMed.
- Aligning treatment to physiology: when to use chronotherapy, block and replace, or titration to treat hypercortisolism.Journal of the Endocrine Society · 2026Article
- Clinical and Biochemical Progression in a Patient With Cortisol-Producing Adenoma.JCEM case reports · 2026Article
- An Analysis of Post-Adrenalectomy Dynamics in MACS (Mild Autonomous Cortisol Secretion)-Positive Adrenal Tumours: The Biomarkers and Clinical Impact.Journal of clinical medicine · 2025Review
- Changes in clinical features of adrenal Cushing syndrome: a national registry study.Endocrine connections · 2025Article
Corrections and comments
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Authors and funding
14 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Objective Cortisol-producing adenoma (CPA) is a major subtype of functional adrenal tumors. CPAs are generally treated with adrenalectomy; however, it is difficult to predict the ideal duration of glucocorticoid replacement after resection. This study explored pre-operative factors predictive of glucocorticoid replacement therapy duration after CPA resection. Mehtods This multicenter retrospective observational study was conducted as part of the Advancing Care and Pathogenesis of Intractable Adrenal Diseases in Japan (ACPA-J) from January 2006 to December 2015. Patients This study was conducted at 10 referral centers and included 124 patients who received hydrocortisone replacement therapy after adrenalectomy for CPA. Results The median duration of replacement therapy was 12 (interquartile range, 5-24) months. In the single regression analysis, the sex (p=0.04), morning adrenocorticotropic hormone (ACTH) level (p=0.02), morning serum cortisol level (p=0.003), midnight serum cortisol level (p<0.001), serum cortisol level after a 1-mg dexamethasone suppression test (p<0.001), presence of lumbar compression fracture (p=0.015), and Cushingoid appearance (p<0.001) were all significantly associated with the replacement therapy duration. In multiple regression analyses, the midnight serum cortisol level and presence of lumbar compression fracture were significantly correlated with the replacement therapy duration after adjusting for other parameters. Conclusion Our results suggest that high midnight serum cortisol levels, which cause persistent suppression of the hypothalamic-pituitary-adrenal axis (HPA axis), contribute to a delay in HPA axis recovery. Lumbar compression fracture is an important symptom that reflects the severity and persistence of cortisol secretion.
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