Predicting factors of recurrence in patients with Cushing's Disease
Journal Title: Kocaeli Tıp Dergisi - Year 2017, Vol 6, Issue 3
Abstract
INTRODUCTION: Introduction: Cushing's Disease (CD) has high recurrence rate therefore clinical features predicting recurrence should be defined to discriminate patients with high risk. These factors can effect management and follow-up frequency. Aim: We aimed to compare the clinical features of the patients with recurrent CD (RD) and sustained remission (SR) in order to determine clinical factors that might predict disease recurrence. METHODS: Surgically treated 85 patients with CD were evaluated retrospectively. Preoperative diagnostic tests and postoperative disease activity were noted. Pituitary tumor size, invasiveness and features such as p53 and Ki-67 immunohistochemical staining data also postoperative cortisol axis recovery time were evaluated. RESULTS: 16 RD and 54 SR patients were enrolled to the study. Preoperative ACTH but not cortisol levels were higher in RD group. RD patients had higher preoperative adenoma size and cavernous sinus invasion rate and Ki-67 index than SR group. Eleven (69%) patients with RD had early recovery time while 6 (11%) patients in SR group. DISCUSSION AND CONCLUSION: Higher preoperative ACTH levels, tumor size, cavernous sinus invasion and Ki-67 immunostaining would predict recurrence in CD. Additionally, rapid recovery of cortisol axis was found to be related with recurrence.
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