Accuracy of Late-Night Salivary XXXX in Evaluating Postoperative Remission and Recurrence in @entity699 .

@entity1 @entity1104 @entity701 @entity699
CONTEXT: Late-night salivary @entity701 (LNSC) is well-validated in the diagnosis of @entity699 ( @entity699 ). The accuracy of LNSC during follow-up of @entity1 undergoing @entity1104 ( @entity1104 ) has not been fully characterized. OBJECTIVES: We examined the accuracy of LNSC in establishing remission and identifying recurrence in postoperative @entity1 with @entity699 . DESIGN: This is a retrospective study. @entity1 : Records of @entity1 with @entity699 who underwent @entity1104 by a single neurosurgeon in our tertiary center (2005-2014) were analyzed (N = 224). @entity1 were selected for further investigation (n = 165) if there was at least one available LNSC test obtained after @entity1104 (either within 3 months or during long-term follow-up). Extracted data included demographic and clinical characteristics, magnetic resonance imaging and laboratory data (morning serum @entity701 , 24-hour urine free @entity701 [UFC], LNSC) . MAIN OUTCOMES AND MEASURES: Remission was defined as nadir morning serum @entity701 less than 5 mcg/dl and nadir 24-hour UFC less than 23 mcg. Recurrence was considered definite if confirmed surgically or prompted radiotherapy. RESULTS: Surgical remission occurred in 89% of 89 @entity1 with available LNSC data. LNSC, obtained within 3 months of @entity1104 , established remission with 94% sensitivity and 80% specificity at a cutpoint of 1.9 nmol/l (area under the curve [AUC] = 0.90). At a median follow-up of 53.5 months, LNSC established recurrence (75% sensitivity and 95% specificity) at a cutpoint of 7.4 nmol/l (AUC = 0.87), and 24-hour UFC established recurrence (68% sensitivity and 100% specificity) at a cutpoint of 1.6-fold above normal (AUC = 0.82). CONCLUSIONS: LNSC may accurately establish remission after @entity1104 and identify recurrence more accurately than 24-hour UFC during long-term follow-up.
