Cushing Disease Clinical Phenotype and Tumor Behavior Vary With Age: Diagnostic and Perioperative Implications
Authors' conclusion
There are age-dependent differences in clinical presentation, tumor behavior, and postoperative outcomes in patients with CD. Compared to younger patients, older patients present with a less classic phenotype characterized by fewer hallmark features, more medical comorbidities, and larger tumors. Notably, age-related differences suggest a more indolent tumor behavior in older patients, potentially contributing to delayed diagnosis and increased perioperative risk. These findings underscore the need for tailored diagnostic and therapeutic approaches across age groups, with a focus on managing long-term comorbidities and optimizing surgical outcomes.
Study context
- Population
- Patients with Cushing disease (CD) treated with transsphenoidal tumor resection at 11 centers, 2003–2023 (RAPID registry)81.6% female
- Participants
- 608 patients
- Exposure
- Association of age with presentation, tumour characteristics and postoperative outcomes
- Outcome
- Age-associated differences in CD
Methodological detailsmulti-institutional, 11 centers
- Multi-institutional
- 11 centers
Main finding
As reported in the abstract
Median age at surgery
44 years
range, 10–78 years
Observational data: associations, not effects.
Safety
Postoperative complications
- Rates of postoperative thromboembolic disease increased with age
Original publication
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