Long‐term Results in 64 Patients Operated Upon for Pheochromocytoma

Abstract

ABSTRACT. During the years 1956–1982, 64 pheochromocytoma patients were operated upon without mortality. Twenty‐eight patients had sustained hypertension and 29 paroxysmal hypertension only. In two patients high blood pressure was not related to pheochromocytoma and five subjects were normotensive. In two women the pheochromocytoma demonstrated malignancy by widespread metastases. Sixteen patients also had neuroectodermal manifestations other than pheochromocytoma. Preoperatively, heart disease was found in most of the hypertensive patients aged 50 years or more at operation, but was uncommon in the others. In these subjects, heart disease persisted after surgery. Young subjects with sustained hypertension were not less affected by preoperative cerebrovascular accidents than older subjects. After surgery, hypertension persisted in 12 patients, and was easily controlled by drug therapy in eight. Nine patients died 7 months‐18 years after surgery. In no case was the death directly associated with the pheochromocytoma disease. Three died from other neuroectodermal abnormalities. The 55 surviving patients have been followed up for a mean of 12 years after surgery. During the observation time the survival of the pheochromocytoma patients was similar to that of the normal population. At the end of the study, 44 out of the 55 surviving patients were free from symptoms.

Metastases but not cardiovascular mortality reduces life expectancy following surgical resection of apparently benign pheochromocytoma

“…In a Swedish cohort of 121 patients, 42 patients died during the observation period versus 23.1 expected deaths in the control population (P!0.001; Khorram-Manesh et al 2005). In a prior study performed at the same centre, however, the observed and expected mortality were similar (Stenstrom et al 1988). Our study confirms that patients with successfully resected PHEO still have a reduced life expectancy.…”

“…Estimates of benign and malignant recurrence rate after surgery vary between 6 and 23% (Modlin et al 1979, Scott & Halter 1984, van Heerden et al 1990, Pruszczyk et al 1991, Plouin et al 1997. Conflicting results of previous cohort studies suggest that the life expectancy after PHEO surgery is either normal (Stenstrom et al 1988) or decreased (Khorram-Manesh et al 2005) when compared with the general population. Furthermore, though PHEO is generally considered to be a surgically curable cause of secondary hypertension, blood pressure remains elevated after surgery in a considerable number of patients without recurrent disease (Plouin et al 1997, Khorram-Manesh et al 2005.…”

“…Survival after uncomplicated PHEO surgery was lower than in a Dutch reference population. In two previous studies, the survival after PHEO surgery was compared with the expected life expectancy of a general reference population (Stenstrom et al 1988, Khorram-Manesh et al 2005. In a Swedish cohort of 121 patients, 42 patients died during the observation period versus 23.1 expected deaths in the control population (P!0.001; Khorram-Manesh et al 2005).…”

MANAGEMENT OF ENDOCRINE DISEASE: Recurrence or new tumors after complete resection of pheochromocytomas and paragangliomas: a systematic review and meta-analysis

“…All studies were on retrospective cohorts except one on a prospective cohort (44) and one that was a randomized controlled trial (45). Of the 38 studies, 20 were performed in Europe, nine in North America, six in Asia, two in South America, and one in the Middle East.…”

Pheochromocytoma and Paraganglioma

“…The operative mortality at the Mayo Clinic from 1980 to 1986 was 1.3%, or 1 in 77 patients (Sheps et al, 1990). The long-term survival of patients after successful removal of a benign pheochromocytoma is essentially the same as that of age-adjusted normals and with improvement in current technique and multi-disciplinary approach, the procedure seems to be relatively safe (Stenstrom et al, 1988). …”