Transsphenoidal microsurgery is the standard treatment for @entity1 with @entity699 . However, there is general lack of agreement regarding the definition of cure. We studied 58 @entity1 with corrected @entity699 after transsphenoidal surgery for @entity699 . Plasma and urinary @entity701 levels were measured after surgery. After the postsurgical hypocortisolism stage (or periodically in @entity1 without hypocortisolism), urinary free @entity701 , plasma @entity701 at 0800 h and 2300 h, morning @entity701 after 1 mg @entity619 , and @entity701 response to insulin-induced @entity4053 were performed. @entity1 were classified in 3 groups: group I, @entity1 with transient hypocortisolism and @entity774 afterwards; group II, @entity1 with transient hypocortisolism and @entity10204 or the stress response afterwards; and group III, @entity1 without postoperative hypocortisolism. Thirty-three @entity1 were included in group I, 8 in group II, and 17 in group III. Groups I and II were similar in postsurgical plasma @entity701 (46.9 +/- 30.3 vs. 60.7 +/- 38.6 nM) and mean follow-up (69.8 vs. 68.8 months) but were significantly different in their recurrence rate (3.4% vs. 50%, P < 0.001). @entity1 in group III had normal postsurgical plasma and urinary @entity701 but persistent abnormalities in circadian rhythm and stress response. After a mean follow-up of 39.1 months, their recurrence rate was similar to that of group II (64.7% vs. 50%). The complete normalization of the adrenocortical function, which is always preceded by postsurgical hypocortisolism, is associated with a very low recurrence risk and should be considered, in our opinion, the main criterion of surgical cure in @entity699 .

The complete normalization of the adrenocortical function as the criterion of cure after transsphenoidal surgery for XXXX .

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity699 :: ('MESH:D003480', 'Disease') :: ["Cushing's disease", 'hypercortisolism'] @entity4053 :: ('MESH:D007003', 'Disease') :: ['hypoglycemia'] @entity10204 :: ('MESH:D021081', 'Disease') :: ['abnormalities in the circadian rhythm'] @entity619 :: ('MESH:D003907', 'Chemical') :: ['dexamethasone'] @entity701 :: ('MESH:D006854', 'Chemical') :: ['cortisol'] @entity774 :: ('MESH:D000312', 'Disease') :: ['normal hypothalamus-pituitary-adrenal axis']
@entity699 :: (MESH:D003480,Disease) :: ['Cushing's disease']
