Background Evidence on follow-up duration for patients with sporadic pheochromocytomas is absent and current guidelines of the European Society of Endocrinology (ESE), American Association of Clinical Endocrinologists and Endocrine Surgeons (AACE/AAES) and Endocrine Society (ES) are ambiguous about the appropriate duration of follow-up. The aim of this systematic review and meta-analysis is to evaluate the recurrence rate of sporadic pheochromocytomas after curative adrenalectomy. Materials and Methods A literature search in PubMed, Embase and the Cochrane Library was performed. A study was eligible if it included a clear report on the number of sporadic patients, recurrence rate and follow-up duration. Studies with an inclusion period before 1990, <2 years of follow-up, <10 patients and unclear data on sporadic nature of pheochromocytomas were excluded. A meta-analysis on recurrence was performed provided that the heterogeneity was low (I2 < 25%) or intermediate (I2 26-75%). Hozo’s method was used to calculate weighted mean follow-up duration and weighted time to recurrence with combined standard deviations. Results A total of 13 studies, including 430 patients, was included in the synthesis. The meta-analysis results describe a pooled recurrence rate after curative surgery of 3% (95%CI 2-6%, I2 = 0%) with a weighted mean time to recurrence of 49.4 months (SD = 30.7) and a weighted mean follow-up period of 77.3 months (SD = 32.2). Conclusions This meta-analysis shows a very low recurrence rate of 3%. Prospective studies, including economical and health effects of limited follow-up strategies for patients with truly sporadic pheochromocytomas should be considered.
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