Treatment and outcomes of recurrent/persistent Cushing’s disease: a single-center experience

BACKGROUND Although transsphenoidal adenomectomy is the first treatment choice for Cushing's disease (CD), tumor recurrence rates are as high 45%, resulting in a therapeutic challenge endocrinologists and neurosurgeons. For recurrent/persistent CD (RCD/PCD), Repeat surgery (RTSS), radiotherapy, gamma knife radiosurgery (GKRS) or bilateral adrenalectomy may be considered. The purpose of study was to report treatments outcomes RCD/PCD single center. METHODS A retrospective performed on 55 patients from center between 2000 2012 at Peking Union Medical College Hospital (PUMCH). RESULTS Among patients, 43 achieved remission (78%), 11 maintained PCD status (20%). average times after initial Repeated were 43.25±10.3 5.13±4.7 months, respectively (P=0.006); 17.6% experienced within year, 52.9% 1.1-5.0 years. treatments, more effective biochemical serum cortisol adrenocorticotrophic hormone (ACTH) levels than radiotherapy. Delayed occurred 28.9% (11/38) surgery. Considering previous RCD 19.75% when less <3 µg/dL, 51.4% under conditions hypocortisolism 24-hour urinary free (24 UFC) undetectable. CONCLUSIONS RTSS remains recommended option while radiotherapy suggested an adjunctive treatment. Intensive follow-up recommended, with µg/dL undetectable 24 UFC can still experience surgical