Postoperative follow-up of @entity699 using @entity701 , desmopressin and coupled XXXX -desmopressin tests: a head-to-head comparison.

@entity1 @entity2286 @entity699 @entity619 @entity701
OBJECTIVE: Predicting the outcome of @entity1 operated on for @entity699 ( @entity699 ) is a challenging task. Our objective was to assess the accuracy of immediate postsurgical plasma @entity701 , desmopressin test and the coupled @entity619 -desmopressin test (CDDT) as predictors of outcome. DESIGN AND @entity1 : Sixty-seven @entity1 with initial remission and a minimal postsurgical follow-up greater than 18  months were included in this retrospective bicentre study. MEASUREMENTS: Follow-up included 3-6  months followed by yearly 24-h urinary-free @entity701 , ACTH and @entity701 plasmatic levels, a 1-mg overnight @entity619 suppression test (1-mg DST), desmopressin test and the CDDT. ROC curves were performed to define the optimal threshold of immediate postsurgical @entity701 level and 3- to 6-month desmopressin test and CDDT, as predictors of final outcome in comparison with classical biological markers of recurrence. RESULTS: Eleven @entity1 presented recurrence. The @entity1 's median follow-up was 52  months (range, 18-180). As early predictors of outcome, immediate postsurgical plasma @entity701 level <35  nmol/l predicted the lack of recurrence with 93% negative predictive value (NPV), whereas predictive positive value ( @entity2286 ) was 25%. During the follow-up, the CDDT was more precise than the desmopressin test in predicting the lack of recurrence (100% NPV) when performed in the first 3  years after surgery. Positivity of the CDDT was defined based on ROC curves by ACTH and @entity701 increments >50%. The CDDT was highly reproducible, as the same response was observed every year in 91% of the @entity1 . CONCLUSIONS: Adding the CDDT the first 3  years after surgery to immediate postsurgical @entity701 evaluation should allow obtaining an optimal follow-up management of @entity1 operated for @entity699 .
