Cushing syndrome is associated with worse survival and higher morbidity in neuroendocrine neoplasms
Authors' conclusion
ECS-compatible Cushing syndrome was associated with worse survival and substantially higher morbidity in patients with NENs, mainly reflected by hypercortisolism-related complications rather than tumor progression.
Study context
- Population
- Adults (≥18 years) with NEN, international healthcare organizations (TriNetX)264 vs 264 after matching
- Participants
- 105,854 adults
- Exposure
- Ectopic Cushing syndrome (ECS)-compatible Cushing syndrome vs no documented Cushing syndrome
- ECSn = 264
- Non-ECSn = 264reference
- Outcome
- OS
Methodological details1:1 propensity score matching, federated database (TriNetX Global Collaborative Network)
- 1:1 propensity score matching
- Federated database (TriNetX Global Collaborative Network)
Main finding
As reported in the abstract
8-year survival
Hazard ratio
1.848
95% CI 1.348–2.534
P < 0.001
By group
Observational data: associations, not effects.
Secondary outcomes
Hospitalization, emergency care use, metabolic complications, organ failure
- ECS patients had increased risks of hospitalization and metabolic complications including hypertension, DM and hypokalemia, as well as organ failure (kidney and liver failure)
Metastatic progression
- No significant increase in metastatic progression
Safety
- ECS patients had increased risks of severe infections and VTE
Original publication
Cushing syndrome is associated with worse survival and higher morbidity in neuroendocrine neoplasms. J Clin Endocrinol Metab. Published 23 July 2026. doi:10.
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