A study examining Cushing’s syndrome reveals one in four patients experience a recurrence of symptoms after undergoing surgical removal of the underlying tumour.
Researchers stress the urgent need for early clinical intervention to reduce the risk of tumour reoccurrence.
Cushing’s syndrome encompasses various disorders characterised by excessive cortisol levels. It can stem from benign tumours in the pituitary or adrenal glands or ectopic production of adrenocorticotropic hormone (ACTH) elsewhere in the body.
Differentiating between the causes of Cushing’s syndrome is crucial, as researchers found it significantly predicts symptom recurrence after surgery.
The study in China involved 202 adults diagnosed with Cushing’s between 2012 and 2022 at The First Hospital of Jilin University.
Of these patients, 122 had Cushing’s disease, 71 had Cushing’s due to adrenal adenomas, and nine had ectopic Cushing’s.
Despite tumour removal surgery, about 25% of patients experienced symptom relapse within approximately nine years post-operation, with higher recurrence rates observed in those with Cushing’s disease compared to adenomas (38% vs 9%).
Certain demographic and clinical factors, such as age over 50, smaller tumour size, and specific laboratory abnormalities, were identified as potential risk factors for earlier recurrence.
This study underscores the importance of early intervention and close monitoring for individuals with Cushing’s syndrome.
Identifying the underlying cause of the disease can significantly aid in predicting its likelihood of recurrence, allowing clinicians to tailor treatment strategies accordingly.
Common symptoms of Cushing’s syndrome include hypertension, central obesity, and diabetes. However, the study revealed variations in symptom presentation depending on the underlying cause of the disease.
For example, fatigue was more frequently reported as the initial symptom in patients with ectopic Cushing’s, while central obesity and diabetes varied in frequency across different subtypes of the syndrome.
The study also highlighted the cardiovascular implications of hypercortisolism, with about 22% of patients exhibiting structural heart abnormalities.
These findings emphasise the complex nature of Cushing’s syndrome and the importance of comprehensive management strategies.
Moving forward, researchers advocate for further investigation into the intricate mechanisms underlying Cushing’s syndrome and its recurrence post-surgery.
The study was published in Scientific Reports.
