Outcomes for Patients with Obesity Undergoing Adrenalectomy for Pheochromocytoma: An International Multicenter Analysis

Kevin Verhoeff; Alessandro Parente; Yanbo Wang; Nanya Wang; Zhicheng Wang; Maciej Śledziński; Andrzej Hellmann; Marco Raffaelli; Francesco Pennestrì; Mark Sywak; Alexander J Papachristos; Fausto F Palazzo; Tae-Yon Sung; Byung-Chang Kim; Yu-Mi Lee; Fiona Eatock; Hannah Anderson; Maurizio Iacobone; Albertas Daukša; Ozer Makay; Yigit Turk; Hafize Basut Atalay; Els J M Nieveen van Dijkum; Anton F Engelsman; Isabelle Holscher; Gabriele Materazzi; Leonardo Rossi; Chiara Becucci; Susannah L Shore; Clare Fung; Alison Waghorn; Radu Mihai; Sabapathy P Balasubramanian; Arslan Pannu; Shuichi Tatarano; David Velázquez-Fernández; Julie A Miller; Hazel Serrao-Brown; Yufei Chen; Marco Stefano Demarchi; Reza Djafarrian; Helen Doran; Kelvin Wang; Michael J Stechman; Helen Perry; Johnathan Hubbard; Cristina Lamas; Philippa Mercer; Janet MacPherson; Supanut Lumbiganon; María Calatayud; Felicia Alexandra Hanzu; Oscar Vidal; Marta Araujo-Castro; Cesar Minguez Ojeda; Theodosios Papavramidis; Pablo Rodríguez de Vera Gómez; Abdulaziz Aldrees; Tariq Altwjry; Nuria Valdés; Cristina Álvarez-Escola; Iñigo García Sanz; Concepción Blanco Carrera; Laura Manjón-Miguélez; Paz De Miguel Novoa; Mónica Recasens; Rogelio García Centeno; Cristina Robles Lázaro; Klaas Van Den Heede; Sam Van Slycke; Theodora Michalopoulou; Sebastian Aspinall; Ross Melvin; Joel Wen Liang Lau; Wei Keat Cheah; Man Hon Tang; Han Boon Oh; John Ayuk; Robert P Sutcliffe

doi:10.1245/s10434-024-16591-0

Outcomes for Patients with Obesity Undergoing Adrenalectomy for Pheochromocytoma: An International Multicenter Analysis

Kevin Verhoeff, Alessandro Parente^*, Yanbo Wang, Nanya Wang, Zhicheng Wang, Maciej Śledziński, Andrzej Hellmann, Marco Raffaelli, Francesco Pennestrì, Mark Sywak, Alexander J Papachristos, Fausto F Palazzo, Tae-Yon Sung, Byung-Chang Kim, Yu-Mi Lee, Fiona Eatock, Hannah Anderson, Maurizio Iacobone, Albertas Daukša, Ozer MakayYigit Turk, Hafize Basut Atalay, Els J M Nieveen van Dijkum, Anton F Engelsman, Isabelle Holscher, Gabriele Materazzi, Leonardo Rossi, Chiara Becucci, Susannah L Shore, Clare Fung, Alison Waghorn, Radu Mihai, Sabapathy P Balasubramanian, Arslan Pannu, Shuichi Tatarano, David Velázquez-Fernández, Julie A Miller, Hazel Serrao-Brown, Yufei Chen, Marco Stefano Demarchi, Reza Djafarrian, Helen Doran, Kelvin Wang, Michael J Stechman, Helen Perry, Johnathan Hubbard, Cristina Lamas, Philippa Mercer, Janet MacPherson, Supanut Lumbiganon, María Calatayud, Felicia Alexandra Hanzu, Oscar Vidal, Marta Araujo-Castro, Cesar Minguez Ojeda, Theodosios Papavramidis, Pablo Rodríguez de Vera Gómez, Abdulaziz Aldrees, Tariq Altwjry, Nuria Valdés, Cristina Álvarez-Escola, Iñigo García Sanz, Concepción Blanco Carrera, Laura Manjón-Miguélez, Paz De Miguel Novoa, Mónica Recasens, Rogelio García Centeno, Cristina Robles Lázaro, Klaas Van Den Heede, Sam Van Slycke, Theodora Michalopoulou, Sebastian Aspinall, Ross Melvin, Joel Wen Liang Lau, Wei Keat Cheah, Man Hon Tang, Han Boon Oh, John Ayuk, Robert P Sutcliffe

^*Autore corrispondente per questo lavoro

Risultato della ricerca: Contributo in rivista › Articolo

Abstract

Objective: The impact of obesity on outcomes after adrenalectomy for pheochromocytoma is unclear. This study aims to evaluate outcomes after minimally invasive and open adrenalectomy for pheochromocytoma in patients with obesity and to determine factors that may affect outcomes. Summary Background Data: Patients undergoing adrenalectomy for pheochromocytoma in 46 international centers between 2012 and 2022 were reviewed, analyzing baseline information, length of hospital stay (LOS), and postoperative complications. Patients and Methods: Obese (body mass index (BMI) ≥ 30 kg/m2) and nonobese patients were compared. Multivariable analysis was utilized to evaluate outcomes and risk factors for complications, LOS, and increased comprehensive complication index (CCI). Results: Of the 2016 patients, 639 (31.7%) had obesity. Operative time (110.0 versus 105.0 min; p = 0.467), conversion to open rate (3.1% versus 4.7%; p = 0.079), estimated blood loss (20.0 versus 20.0 ml, p = 0.088), rate of complications (19.3% versus 20.8%; p = 0.425), and CCI were similar. However, patients with obesity required a median of 1 day longer LOS (4.0 days versus 5.0 days; p < 0.001). On multivariable analysis, obesity was not significantly associated with complications or higher CCI. Analyzing solely obese patients, laparoscopic (OR 0.24; p < 0.001) and robotic (OR 0.22; p = 0.011) approaches were independently associated with less morbidity. Additionally, multivariable modeling demonstrated that a retroperitoneal approach in patients with BMI ≥ 30 kg/m2 was independently associated with reduced CCI (− 3.74; p = 0.017). Similar results were demonstrated when analyzing severe obesity (BMI ≥ 35). Conclusions: Obesity does not increase complications or CCI following pheochromocytoma resection, but it does increase LOS. A retroperitoneal approach may uniquely benefit patients with obesity. In view of rising obesity rates, these results warrant further research to validate findings.

Lingua originale	Inglese
pagine (da-a)	1709-1720
Numero di pagine	12
Rivista	Annals of Surgical Oncology
Volume	32
Numero di pubblicazione	3
DOI	https://doi.org/10.1245/s10434-024-16591-0
Stato di pubblicazione	Pubblicato - 2025

All Science Journal Classification (ASJC) codes

Chirurgia
Oncologia

Keywords

Laparoscopic adrenalectomy
Obesity
Pheochromocytoma
Postoperative complications
Robotic adrenalectomy

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10.1245/s10434-024-16591-0

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Verhoeff, K., Parente, A., Wang, Y., Wang, N., Wang, Z., Śledziński, M., Hellmann, A., Raffaelli, M., Pennestrì, F., Sywak, M., Papachristos, A. J., Palazzo, F. F., Sung, T.-Y., Kim, B.-C., Lee, Y.-M., Eatock, F., Anderson, H., Iacobone, M., Daukša, A., ... Sutcliffe, R. P. (2025). Outcomes for Patients with Obesity Undergoing Adrenalectomy for Pheochromocytoma: An International Multicenter Analysis. Annals of Surgical Oncology, 32(3), 1709-1720. https://doi.org/10.1245/s10434-024-16591-0

@article{567d2f3d26d147d08a51c70b2051e19e,

title = "Outcomes for Patients with Obesity Undergoing Adrenalectomy for Pheochromocytoma: An International Multicenter Analysis",

abstract = "Objective: The impact of obesity on outcomes after adrenalectomy for pheochromocytoma is unclear. This study aims to evaluate outcomes after minimally invasive and open adrenalectomy for pheochromocytoma in patients with obesity and to determine factors that may affect outcomes. Summary Background Data: Patients undergoing adrenalectomy for pheochromocytoma in 46 international centers between 2012 and 2022 were reviewed, analyzing baseline information, length of hospital stay (LOS), and postoperative complications. Patients and Methods: Obese (body mass index (BMI) ≥ 30 kg/m2) and nonobese patients were compared. Multivariable analysis was utilized to evaluate outcomes and risk factors for complications, LOS, and increased comprehensive complication index (CCI). Results: Of the 2016 patients, 639 (31.7\%) had obesity. Operative time (110.0 versus 105.0 min; p = 0.467), conversion to open rate (3.1\% versus 4.7\%; p = 0.079), estimated blood loss (20.0 versus 20.0 ml, p = 0.088), rate of complications (19.3\% versus 20.8\%; p = 0.425), and CCI were similar. However, patients with obesity required a median of 1 day longer LOS (4.0 days versus 5.0 days; p < 0.001). On multivariable analysis, obesity was not significantly associated with complications or higher CCI. Analyzing solely obese patients, laparoscopic (OR 0.24; p < 0.001) and robotic (OR 0.22; p = 0.011) approaches were independently associated with less morbidity. Additionally, multivariable modeling demonstrated that a retroperitoneal approach in patients with BMI ≥ 30 kg/m2 was independently associated with reduced CCI (− 3.74; p = 0.017). Similar results were demonstrated when analyzing severe obesity (BMI ≥ 35). Conclusions: Obesity does not increase complications or CCI following pheochromocytoma resection, but it does increase LOS. A retroperitoneal approach may uniquely benefit patients with obesity. In view of rising obesity rates, these results warrant further research to validate findings.",

keywords = "Laparoscopic adrenalectomy, Obesity, Pheochromocytoma, Postoperative complications, Robotic adrenalectomy, Laparoscopic adrenalectomy, Obesity, Pheochromocytoma, Postoperative complications, Robotic adrenalectomy",

author = "Kevin Verhoeff and Alessandro Parente and Yanbo Wang and Nanya Wang and Zhicheng Wang and Maciej {\'S}ledzi{\'n}ski and Andrzej Hellmann and Marco Raffaelli and Francesco Pennestr{\`i} and Mark Sywak and Papachristos, \{Alexander J\} and Palazzo, \{Fausto F\} and Tae-Yon Sung and Byung-Chang Kim and Yu-Mi Lee and Fiona Eatock and Hannah Anderson and Maurizio Iacobone and Albertas Dauk{\v s}a and Ozer Makay and Yigit Turk and Atalay, \{Hafize Basut\} and \{van Dijkum\}, \{Els J M Nieveen\} and Engelsman, \{Anton F\} and Isabelle Holscher and Gabriele Materazzi and Leonardo Rossi and Chiara Becucci and Shore, \{Susannah L\} and Clare Fung and Alison Waghorn and Radu Mihai and Balasubramanian, \{Sabapathy P\} and Arslan Pannu and Shuichi Tatarano and David Vel{\'a}zquez-Fern{\'a}ndez and Miller, \{Julie A\} and Hazel Serrao-Brown and Yufei Chen and Demarchi, \{Marco Stefano\} and Reza Djafarrian and Helen Doran and Kelvin Wang and Stechman, \{Michael J\} and Helen Perry and Johnathan Hubbard and Cristina Lamas and Philippa Mercer and Janet MacPherson and Supanut Lumbiganon and Mar{\'i}a Calatayud and Hanzu, \{Felicia Alexandra\} and Oscar Vidal and Marta Araujo-Castro and Ojeda, \{Cesar Minguez\} and Theodosios Papavramidis and \{de Vera G{\'o}mez\}, \{Pablo Rodr{\'i}guez\} and Abdulaziz Aldrees and Tariq Altwjry and Nuria Vald{\'e}s and Cristina {\'A}lvarez-Escola and \{Garc{\'i}a Sanz\}, I{\~n}igo and \{Blanco Carrera\}, Concepci{\'o}n and Laura Manj{\'o}n-Migu{\'e}lez and \{De Miguel Novoa\}, Paz and M{\'o}nica Recasens and \{Garc{\'i}a Centeno\}, Rogelio and \{Robles L{\'a}zaro\}, Cristina and \{Van Den Heede\}, Klaas and \{Van Slycke\}, Sam and Theodora Michalopoulou and Sebastian Aspinall and Ross Melvin and Lau, \{Joel Wen Liang\} and Cheah, \{Wei Keat\} and Tang, \{Man Hon\} and Oh, \{Han Boon\} and John Ayuk and Sutcliffe, \{Robert P\}",

year = "2025",

doi = "10.1245/s10434-024-16591-0",

language = "English",

volume = "32",

pages = "1709--1720",

journal = "Annals of Surgical Oncology",

issn = "1534-4681",

publisher = "Springer Science and Business Media Deutschland GmbH",

number = "3",

}

Verhoeff, K, Parente, A, Wang, Y, Wang, N, Wang, Z, Śledziński, M, Hellmann, A, Raffaelli, M, Pennestrì, F, Sywak, M, Papachristos, AJ, Palazzo, FF, Sung, T-Y, Kim, B-C, Lee, Y-M, Eatock, F, Anderson, H, Iacobone, M, Daukša, A, Makay, O, Turk, Y, Atalay, HB, van Dijkum, EJMN, Engelsman, AF, Holscher, I, Materazzi, G, Rossi, L, Becucci, C, Shore, SL, Fung, C, Waghorn, A, Mihai, R, Balasubramanian, SP, Pannu, A, Tatarano, S, Velázquez-Fernández, D, Miller, JA, Serrao-Brown, H, Chen, Y, Demarchi, MS, Djafarrian, R, Doran, H, Wang, K, Stechman, MJ, Perry, H, Hubbard, J, Lamas, C, Mercer, P, MacPherson, J, Lumbiganon, S, Calatayud, M, Hanzu, FA, Vidal, O, Araujo-Castro, M, Ojeda, CM, Papavramidis, T, de Vera Gómez, PR, Aldrees, A, Altwjry, T, Valdés, N, Álvarez-Escola, C, García Sanz, I, Blanco Carrera, C, Manjón-Miguélez, L, De Miguel Novoa, P, Recasens, M, García Centeno, R, Robles Lázaro, C, Van Den Heede, K, Van Slycke, S, Michalopoulou, T, Aspinall, S, Melvin, R, Lau, JWL, Cheah, WK, Tang, MH, Oh, HB, Ayuk, J & Sutcliffe, RP 2025, 'Outcomes for Patients with Obesity Undergoing Adrenalectomy for Pheochromocytoma: An International Multicenter Analysis', Annals of Surgical Oncology, vol. 32, n. 3, pagg. 1709-1720. https://doi.org/10.1245/s10434-024-16591-0

TY - JOUR

T1 - Outcomes for Patients with Obesity Undergoing Adrenalectomy for Pheochromocytoma: An International Multicenter Analysis

AU - Verhoeff, Kevin

AU - Parente, Alessandro

AU - Wang, Yanbo

AU - Wang, Nanya

AU - Wang, Zhicheng

AU - Śledziński, Maciej

AU - Hellmann, Andrzej

AU - Raffaelli, Marco

AU - Pennestrì, Francesco

AU - Sywak, Mark

AU - Papachristos, Alexander J

AU - Palazzo, Fausto F

AU - Sung, Tae-Yon

AU - Kim, Byung-Chang

AU - Lee, Yu-Mi

AU - Eatock, Fiona

AU - Anderson, Hannah

AU - Iacobone, Maurizio

AU - Daukša, Albertas

AU - Makay, Ozer

AU - Turk, Yigit

AU - Atalay, Hafize Basut

AU - van Dijkum, Els J M Nieveen

AU - Engelsman, Anton F

AU - Holscher, Isabelle

AU - Materazzi, Gabriele

AU - Rossi, Leonardo

AU - Becucci, Chiara

AU - Shore, Susannah L

AU - Fung, Clare

AU - Waghorn, Alison

AU - Mihai, Radu

AU - Balasubramanian, Sabapathy P

AU - Pannu, Arslan

AU - Tatarano, Shuichi

AU - Velázquez-Fernández, David

AU - Miller, Julie A

AU - Serrao-Brown, Hazel

AU - Chen, Yufei

AU - Demarchi, Marco Stefano

AU - Djafarrian, Reza

AU - Doran, Helen

AU - Wang, Kelvin

AU - Stechman, Michael J

AU - Perry, Helen

AU - Hubbard, Johnathan

AU - Lamas, Cristina

AU - Mercer, Philippa

AU - MacPherson, Janet

AU - Lumbiganon, Supanut

AU - Calatayud, María

AU - Hanzu, Felicia Alexandra

AU - Vidal, Oscar

AU - Araujo-Castro, Marta

AU - Ojeda, Cesar Minguez

AU - Papavramidis, Theodosios

AU - de Vera Gómez, Pablo Rodríguez

AU - Aldrees, Abdulaziz

AU - Altwjry, Tariq

AU - Valdés, Nuria

AU - Álvarez-Escola, Cristina

AU - García Sanz, Iñigo

AU - Blanco Carrera, Concepción

AU - Manjón-Miguélez, Laura

AU - De Miguel Novoa, Paz

AU - Recasens, Mónica

AU - García Centeno, Rogelio

AU - Robles Lázaro, Cristina

AU - Van Den Heede, Klaas

AU - Van Slycke, Sam

AU - Michalopoulou, Theodora

AU - Aspinall, Sebastian

AU - Melvin, Ross

AU - Lau, Joel Wen Liang

AU - Cheah, Wei Keat

AU - Tang, Man Hon

AU - Oh, Han Boon

AU - Ayuk, John

AU - Sutcliffe, Robert P

PY - 2025

Y1 - 2025

N2 - Objective: The impact of obesity on outcomes after adrenalectomy for pheochromocytoma is unclear. This study aims to evaluate outcomes after minimally invasive and open adrenalectomy for pheochromocytoma in patients with obesity and to determine factors that may affect outcomes. Summary Background Data: Patients undergoing adrenalectomy for pheochromocytoma in 46 international centers between 2012 and 2022 were reviewed, analyzing baseline information, length of hospital stay (LOS), and postoperative complications. Patients and Methods: Obese (body mass index (BMI) ≥ 30 kg/m2) and nonobese patients were compared. Multivariable analysis was utilized to evaluate outcomes and risk factors for complications, LOS, and increased comprehensive complication index (CCI). Results: Of the 2016 patients, 639 (31.7%) had obesity. Operative time (110.0 versus 105.0 min; p = 0.467), conversion to open rate (3.1% versus 4.7%; p = 0.079), estimated blood loss (20.0 versus 20.0 ml, p = 0.088), rate of complications (19.3% versus 20.8%; p = 0.425), and CCI were similar. However, patients with obesity required a median of 1 day longer LOS (4.0 days versus 5.0 days; p < 0.001). On multivariable analysis, obesity was not significantly associated with complications or higher CCI. Analyzing solely obese patients, laparoscopic (OR 0.24; p < 0.001) and robotic (OR 0.22; p = 0.011) approaches were independently associated with less morbidity. Additionally, multivariable modeling demonstrated that a retroperitoneal approach in patients with BMI ≥ 30 kg/m2 was independently associated with reduced CCI (− 3.74; p = 0.017). Similar results were demonstrated when analyzing severe obesity (BMI ≥ 35). Conclusions: Obesity does not increase complications or CCI following pheochromocytoma resection, but it does increase LOS. A retroperitoneal approach may uniquely benefit patients with obesity. In view of rising obesity rates, these results warrant further research to validate findings.

AB - Objective: The impact of obesity on outcomes after adrenalectomy for pheochromocytoma is unclear. This study aims to evaluate outcomes after minimally invasive and open adrenalectomy for pheochromocytoma in patients with obesity and to determine factors that may affect outcomes. Summary Background Data: Patients undergoing adrenalectomy for pheochromocytoma in 46 international centers between 2012 and 2022 were reviewed, analyzing baseline information, length of hospital stay (LOS), and postoperative complications. Patients and Methods: Obese (body mass index (BMI) ≥ 30 kg/m2) and nonobese patients were compared. Multivariable analysis was utilized to evaluate outcomes and risk factors for complications, LOS, and increased comprehensive complication index (CCI). Results: Of the 2016 patients, 639 (31.7%) had obesity. Operative time (110.0 versus 105.0 min; p = 0.467), conversion to open rate (3.1% versus 4.7%; p = 0.079), estimated blood loss (20.0 versus 20.0 ml, p = 0.088), rate of complications (19.3% versus 20.8%; p = 0.425), and CCI were similar. However, patients with obesity required a median of 1 day longer LOS (4.0 days versus 5.0 days; p < 0.001). On multivariable analysis, obesity was not significantly associated with complications or higher CCI. Analyzing solely obese patients, laparoscopic (OR 0.24; p < 0.001) and robotic (OR 0.22; p = 0.011) approaches were independently associated with less morbidity. Additionally, multivariable modeling demonstrated that a retroperitoneal approach in patients with BMI ≥ 30 kg/m2 was independently associated with reduced CCI (− 3.74; p = 0.017). Similar results were demonstrated when analyzing severe obesity (BMI ≥ 35). Conclusions: Obesity does not increase complications or CCI following pheochromocytoma resection, but it does increase LOS. A retroperitoneal approach may uniquely benefit patients with obesity. In view of rising obesity rates, these results warrant further research to validate findings.

KW - Laparoscopic adrenalectomy

KW - Obesity

KW - Pheochromocytoma

KW - Postoperative complications

KW - Robotic adrenalectomy

KW - Laparoscopic adrenalectomy

KW - Obesity

KW - Pheochromocytoma

KW - Postoperative complications

KW - Robotic adrenalectomy

UR - https://publicatt.unicatt.it/handle/10807/322377

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UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85211817661&origin=inward

U2 - 10.1245/s10434-024-16591-0

DO - 10.1245/s10434-024-16591-0

M3 - Article

SN - 1534-4681

VL - 32

SP - 1709

EP - 1720

JO - Annals of Surgical Oncology

JF - Annals of Surgical Oncology

IS - 3

ER -

Outcomes for Patients with Obesity Undergoing Adrenalectomy for Pheochromocytoma: An International Multicenter Analysis

Abstract

All Science Journal Classification (ASJC) codes

Keywords

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