{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T19:24:22Z","timestamp":1783797862525,"version":"3.55.0"},"reference-count":15,"publisher":"Endocrinology Research Centre","issue":"6","license":[{"start":{"date-parts":[[2022,8,15]],"date-time":"2022-08-15T00:00:00Z","timestamp":1660521600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.probl-endojournals.ru\/jour\/about\/editorialPolicies#openAccessPolicy"}],"content-domain":{"domain":["www.probl-endojournals.ru"],"crossmark-restriction":true},"short-container-title":["Probl Endokrinol (Mosk)"],"abstract":"<jats:p><jats:bold>AIM<\/jats:bold>: To determine significant factors affecting the survival of patients with ectopic ACTH syndrome (EAS).<jats:bold>MATERIALS AND METHODS<\/jats:bold>: A multi-center, observational study with a retrospective analysis of patients with EAS. The end point of the study was the fatal outcome of patients from various causes. In order to identify predictors of survival or mortality, univariate and multifactorial Cox regression analyses were carried out. ROC-analysis was used to determine the prognostic threshold values of individual predictors. The survival analysis was carried out using the Kaplan-Mayer method. Statistical data processing was carried out by using IBM SPSS Statistics 23.<jats:bold>RESULTS<\/jats:bold>: The age of patients at the time of diagnosis ranged from 12 to 76 years (Me 40 years [28;54]). The age of the studied population was 55 years [38; 64] for women and 42 years [32; 54] for men. The median period of observation was 50 months [13;91], with a maximum follow-up of 382 months. 92 patients (60,9%) had bronchopulmonary NET, 17 (11,3%) \u2014 thymic carcinoid, 8 \u2014 pancreatic NET, 5 \u2013pheochromocytoma, 1\u2013 cecum NET, 1\u2013 appendix carcinoid tumor, 1 \u2014 medullary thyroid cancer and 26 (17,2%) patients had an occult NET. The primary tumor was removed in 101 patients (66,9%). Bilateral adrenalectomy was performed in 42 (27,8%) cases. Metastases were revealed in 23,2% (n=35) of patients. Relapse of the disease was observed in 24,4%, long-term remission was preserved in 64 patients (74,4%). Death occurred in 42 patients (28%). The average age of survivors was 47,0\u00b115,2 versus 53,5\u00b115,6 years for the deceased (p=0,022). The average survival time from diagnosis for the deceased was 32 months, Me 16,5 months [7;54]. Multivariate analysis revealed that the following factors have a direct impact on survival: age of diagnosis \u226551 years (OR 4,493; 95% CI 2,056\u20139,818, p&lt;0,001), bronchopulmonary neuroendocrine tumor (NET) (OR 0,281; 95% CI 0,119\u20130,665, p=0,004), the presence of distant metastases (OR 2,489; 95% CI 1,141\u20135,427, p=0,022), late-night salivary cortisol (LNSC) \u2265122,2 nmol\/L (OR 2,493; 95% CI 1,014\u20136,128, p=0,047).<jats:bold>CONCLUSION<\/jats:bold>: The prognosis of patients with EAS is influenced by the age of diagnosis, NET localization, distant metastases and level of LNSC. The most common cause of ectopic ACTH syndrome was bronchopulmonary NET which was associated with the best survival rate.<\/jats:p>","DOI":"10.14341\/probl13144","type":"journal-article","created":{"date-parts":[[2023,1,26]],"date-time":"2023-01-26T12:20:40Z","timestamp":1674735640000},"page":"30-42","update-policy":"https:\/\/doi.org\/10.14341\/crossmarkpolicy2018","source":"Crossref","is-referenced-by-count":8,"title":["Survival predictors in patients with ectopic acth syndrome"],"prefix":"10.14341","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2320-1051","authenticated-orcid":true,"given":"O. O.","family":"Golounina","sequence":"first","affiliation":[{"name":"I.M. Sechenov First Moscow State Medical University (Sechenov University)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6674-6441","authenticated-orcid":true,"given":"Zh. E.","family":"Belaya","sequence":"additional","affiliation":[{"name":"Endocrinology Research Centre"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7041-0732","authenticated-orcid":true,"given":"L. Ya.","family":"Rozhinskaya","sequence":"additional","affiliation":[{"name":"Endocrinology Research Centre"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0559-4461","authenticated-orcid":true,"given":"M. Yu.","family":"Pikunov","sequence":"additional","affiliation":[{"name":"The National Medical Research Center of Surgery named after A. V. Vishnevsky"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5548-1724","authenticated-orcid":true,"given":"A. A.","family":"Markovich","sequence":"additional","affiliation":[{"name":"The National Medical Research Center of Oncology named after N. N. Blokhin"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0327-4619","authenticated-orcid":true,"given":"L. K.","family":"Dzeranova","sequence":"additional","affiliation":[{"name":"Endocrinology Research Centre"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5130-4157","authenticated-orcid":true,"given":"E. I.","family":"Marova","sequence":"additional","affiliation":[{"name":"Endocrinology Research Centre"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9419-7013","authenticated-orcid":true,"given":"N. S.","family":"Kuznetsov","sequence":"additional","affiliation":[{"name":"Endocrinology Research Centre"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3026-6315","authenticated-orcid":true,"given":"V. V.","family":"Fadeev","sequence":"additional","affiliation":[{"name":"I.M. Sechenov First Moscow State Medical University (Sechenov University)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5634-7877","authenticated-orcid":true,"given":"G. A.","family":"Melnichenko","sequence":"additional","affiliation":[{"name":"Endocrinology Research Centre"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8175-7886","authenticated-orcid":true,"given":"I. I.","family":"Dedov","sequence":"additional","affiliation":[{"name":"Endocrinology Research Centre"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"5458","published-online":{"date-parts":[[2022,8,15]]},"reference":[{"key":"ref1","doi-asserted-by":"crossref","unstructured":"Lacroix A, Feelders RA, Stratakis CA, Nieman LK. Cushing\u2019s syndrome. 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