• Neurosurgery · Aug 2024

    Multicenter Study

    Multicenter Registry of Adenomas of the Pituitary and Related Disorders: Initial Description of Cushing Disease Cohort, Surgical Outcomes, and Surgeon Characteristics.

    • Andrew S Little, Michael Karsy, James J Evans, Won Kim, Donato R Pacione, Albert H Kim, Paul A Gardner, Benjamin K Hendricks, Christina E Sarris, Ildiko E Torok, Trevor M Low, Tomiko A Crocker, Benita Valappil, Mridu Kanga, Hussein Abdallah, Sarah Collopy, Juan C Fernandez-Miranda, Vera Vigo, Vladimir A Ljubimov, Gabriel Zada, Norman E Garrett, William Delery, YuenKevin C JKCJDepartment of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix , Arizona , USA., Robert C Rennert, William T Couldwell, Julie M Silverstein, Varun R Kshettry, Michael R Chicoine, and RAPID Consortium.
    • Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix , Arizona , USA.
    • Neurosurgery. 2024 Aug 1; 95 (2): 372379372-379.

    Background And ObjectivesTo address the lack of a multicenter pituitary surgery research consortium in the United States, we established the Registry of Adenomas of the Pituitary and Related Disorders (RAPID). The goals of RAPID are to examine surgical outcomes, improve patient care, disseminate best practices, and facilitate multicenter surgery research at scale. Our initial focus is Cushing disease (CD). This study aims to describe the current RAPID patient cohort, explore surgical outcomes, and lay the foundation for future studies addressing the limitations of previous studies.MethodsProspectively and retrospectively obtained data from participating sites were aggregated using a cloud-based registry and analyzed retrospectively. Standard preoperative variables and outcome measures included length of stay, unplanned readmission, and remission.ResultsBy July 2023, 528 patients with CD had been treated by 26 neurosurgeons with varying levels of experience at 9 academic pituitary centers. No surgeon treated more than 81 of 528 (15.3%) patients. The mean ± SD patient age was 43.8 ± 13.9 years, and most patients were female (82.2%, 433/527). The mean tumor diameter was 0.8 ± 2.7 cm. Most patients (76.6%, 354/462) had no prior treatment. The most common pathology was corticotroph tumor (76.8%, 381/496). The mean length of stay was 3.8 ± 2.5 days. The most common discharge destination was home (97.2%, 513/528). Two patients (0.4%, 2/528) died perioperatively. A total of 57 patients (11.0%, 57/519) required an unplanned hospital readmission within 90 days of surgery. The median actuarial disease-free survival after index surgery was 8.5 years.ConclusionThis study examined an evolving multicenter collaboration on patient outcomes after surgery for CD. Our results provide novel insights on surgical outcomes not possible in prior single-center studies or with national administrative data sets. This collaboration will power future studies to better advance the standard of care for patients with CD.Copyright © Congress of Neurological Surgeons 2024. All rights reserved.

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