Postoperative outcomes in normotensive and hypertensive pheochromocytomas: an international study

Marta Araujo-Castro; Aura Herrera; Yanbo 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; 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; Kevin Verhoeff; Robert P Sutcliffe; Alessandro Parente

doi:10.1210/clinem/dgaf154

Postoperative outcomes in normotensive and hypertensive pheochromocytomas: an international study

Marta Araujo-Castro, Aura Herrera, Yanbo 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 TurkHafize 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, 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, Kevin Verhoeff, Robert P Sutcliffe, Alessandro Parente

Risultato della ricerca: Contributo in rivista › Articolo

Abstract

Context: Postoperative outcomes of patients with normotensive pheochromocytomas are poorly documented. Objective: We aimed to evaluate the impact of preoperative hypertension on postoperative outcomes following adrenalectomy for pheochromocytoma. Methods An international retrospective study of patients undergoing adrenalectomy for pheochromocytoma in 46 centers between 2012 and 2022 was performed. Hypertensive and normotensive pheochromocytoma were defined respectively by the presence or absence of hypertension history before or at the time of pheochromocytoma diagnosis. To evaluate differences in postoperative outcomes between hypertensive and normotensive patients, propensity score matched (PSM) analysis was performed. Results: Among 2016 patients with pheochromocytoma, 1034 (51.2%) had preoperative hypertension and 982 (49.8%) were normotensive. Hypertensive patients were 4.5 years older (P < .001), had a higher prevalence of type 2 diabetes (P < .001), had a higher median Charlson Comorbidity Index (2.0 vs 1.0; P < .001), and had an American Society of Anesthesiologists score of III to IV more frequently (41% vs 19.9%; P < .001) than normotensive patients. Nonadjusted analysis demonstrated that hypertensive patients had longer operative time (115.0 vs 103.5 minutes; P = .026), higher rate of vasopressors at skin closure (19.7% vs 15.4%; P = .013), more perioperative blood transfusions (7.7% vs 5.0%; P = .016), and an increased complication rate (21.6% vs 17.7%; P = .029). However, after 1:1 PSM, we found that readmission, complications, and serious complications were similar between cohorts. Conclusion: Patients with hypertensive pheochromocytomas have a higher risk of postoperative complications than normotensive patients due to the association of hypertension with a higher burden of comorbidities and older age. However, hypertension is not an independent risk factor of postoperative complications after pheochromocytoma surgery.

Lingua originale	Inglese
pagine (da-a)	1-11
Numero di pagine	11
Rivista	Journal of Clinical Endocrinology and Metabolism
Numero di pubblicazione	may 26
DOI	https://doi.org/10.1210/clinem/dgaf154
Stato di pubblicazione	Pubblicato - 2025

Keywords

Clavin-Dindo
hypertensive
normotensive
pheochromocytoma
surgical outcomes

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10.1210/clinem/dgaf154

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Araujo-Castro, M., Herrera, A., Wang, Y., 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., Makay, O., ... Parente, A. (2025). Postoperative outcomes in normotensive and hypertensive pheochromocytomas: an international study. Journal of Clinical Endocrinology and Metabolism, (may 26), 1-11. https://doi.org/10.1210/clinem/dgaf154

@article{2ecd8d3b55624693859153754ad51a73,

title = "Postoperative outcomes in normotensive and hypertensive pheochromocytomas: an international study",

abstract = "Context: Postoperative outcomes of patients with normotensive pheochromocytomas are poorly documented. Objective: We aimed to evaluate the impact of preoperative hypertension on postoperative outcomes following adrenalectomy for pheochromocytoma. Methods An international retrospective study of patients undergoing adrenalectomy for pheochromocytoma in 46 centers between 2012 and 2022 was performed. Hypertensive and normotensive pheochromocytoma were defined respectively by the presence or absence of hypertension history before or at the time of pheochromocytoma diagnosis. To evaluate differences in postoperative outcomes between hypertensive and normotensive patients, propensity score matched (PSM) analysis was performed. Results: Among 2016 patients with pheochromocytoma, 1034 (51.2\%) had preoperative hypertension and 982 (49.8\%) were normotensive. Hypertensive patients were 4.5 years older (P < .001), had a higher prevalence of type 2 diabetes (P < .001), had a higher median Charlson Comorbidity Index (2.0 vs 1.0; P < .001), and had an American Society of Anesthesiologists score of III to IV more frequently (41\% vs 19.9\%; P < .001) than normotensive patients. Nonadjusted analysis demonstrated that hypertensive patients had longer operative time (115.0 vs 103.5 minutes; P = .026), higher rate of vasopressors at skin closure (19.7\% vs 15.4\%; P = .013), more perioperative blood transfusions (7.7\% vs 5.0\%; P = .016), and an increased complication rate (21.6\% vs 17.7\%; P = .029). However, after 1:1 PSM, we found that readmission, complications, and serious complications were similar between cohorts. Conclusion: Patients with hypertensive pheochromocytomas have a higher risk of postoperative complications than normotensive patients due to the association of hypertension with a higher burden of comorbidities and older age. However, hypertension is not an independent risk factor of postoperative complications after pheochromocytoma surgery.",

keywords = "Clavin-Dindo, hypertensive, normotensive, pheochromocytoma, surgical outcomes, Clavin-Dindo, hypertensive, normotensive, pheochromocytoma, surgical outcomes",

author = "Marta Araujo-Castro and Aura Herrera and Yanbo 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 \{Basut Atalay\}, Hafize and \{Nieveen van Dijkum\}, \{Els J M\} 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 \{Minguez Ojeda\}, Cesar and Theodosios Papavramidis and \{Rodr{\'i}guez de Vera G{\'o}mez\}, Pablo 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 \{Wen Liang Lau\}, Joel and Cheah, \{Wei Keat\} and \{Hon Tang\}, Man and Oh, \{Han Boon\} and John Ayuk and Kevin Verhoeff and Sutcliffe, \{Robert P\} and Alessandro Parente",

year = "2025",

doi = "10.1210/clinem/dgaf154",

language = "English",

pages = "1--11",

journal = "Journal of Clinical Endocrinology and Metabolism",

issn = "0021-972X",

publisher = "The Endocrine Society",

number = "may 26",

}

Araujo-Castro, M, Herrera, A, Wang, Y, 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, Basut Atalay, H, Nieveen van Dijkum, EJM, 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, Minguez Ojeda, C, Papavramidis, T, Rodríguez de Vera Gómez, P, 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, Wen Liang Lau, J, Cheah, WK, Hon Tang, M, Oh, HB, Ayuk, J, Verhoeff, K, Sutcliffe, RP & Parente, A 2025, 'Postoperative outcomes in normotensive and hypertensive pheochromocytomas: an international study', Journal of Clinical Endocrinology and Metabolism, n. may 26, pagg. 1-11. https://doi.org/10.1210/clinem/dgaf154

TY - JOUR

T1 - Postoperative outcomes in normotensive and hypertensive pheochromocytomas: an international study

AU - Araujo-Castro, Marta

AU - Herrera, Aura

AU - Wang, Yanbo

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 - Basut Atalay, Hafize

AU - Nieveen van Dijkum, Els J M

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 - Minguez Ojeda, Cesar

AU - Papavramidis, Theodosios

AU - Rodríguez de Vera Gómez, Pablo

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 - Wen Liang Lau, Joel

AU - Cheah, Wei Keat

AU - Hon Tang, Man

AU - Oh, Han Boon

AU - Ayuk, John

AU - Verhoeff, Kevin

AU - Sutcliffe, Robert P

AU - Parente, Alessandro

PY - 2025

Y1 - 2025

N2 - Context: Postoperative outcomes of patients with normotensive pheochromocytomas are poorly documented. Objective: We aimed to evaluate the impact of preoperative hypertension on postoperative outcomes following adrenalectomy for pheochromocytoma. Methods An international retrospective study of patients undergoing adrenalectomy for pheochromocytoma in 46 centers between 2012 and 2022 was performed. Hypertensive and normotensive pheochromocytoma were defined respectively by the presence or absence of hypertension history before or at the time of pheochromocytoma diagnosis. To evaluate differences in postoperative outcomes between hypertensive and normotensive patients, propensity score matched (PSM) analysis was performed. Results: Among 2016 patients with pheochromocytoma, 1034 (51.2%) had preoperative hypertension and 982 (49.8%) were normotensive. Hypertensive patients were 4.5 years older (P < .001), had a higher prevalence of type 2 diabetes (P < .001), had a higher median Charlson Comorbidity Index (2.0 vs 1.0; P < .001), and had an American Society of Anesthesiologists score of III to IV more frequently (41% vs 19.9%; P < .001) than normotensive patients. Nonadjusted analysis demonstrated that hypertensive patients had longer operative time (115.0 vs 103.5 minutes; P = .026), higher rate of vasopressors at skin closure (19.7% vs 15.4%; P = .013), more perioperative blood transfusions (7.7% vs 5.0%; P = .016), and an increased complication rate (21.6% vs 17.7%; P = .029). However, after 1:1 PSM, we found that readmission, complications, and serious complications were similar between cohorts. Conclusion: Patients with hypertensive pheochromocytomas have a higher risk of postoperative complications than normotensive patients due to the association of hypertension with a higher burden of comorbidities and older age. However, hypertension is not an independent risk factor of postoperative complications after pheochromocytoma surgery.

AB - Context: Postoperative outcomes of patients with normotensive pheochromocytomas are poorly documented. Objective: We aimed to evaluate the impact of preoperative hypertension on postoperative outcomes following adrenalectomy for pheochromocytoma. Methods An international retrospective study of patients undergoing adrenalectomy for pheochromocytoma in 46 centers between 2012 and 2022 was performed. Hypertensive and normotensive pheochromocytoma were defined respectively by the presence or absence of hypertension history before or at the time of pheochromocytoma diagnosis. To evaluate differences in postoperative outcomes between hypertensive and normotensive patients, propensity score matched (PSM) analysis was performed. Results: Among 2016 patients with pheochromocytoma, 1034 (51.2%) had preoperative hypertension and 982 (49.8%) were normotensive. Hypertensive patients were 4.5 years older (P < .001), had a higher prevalence of type 2 diabetes (P < .001), had a higher median Charlson Comorbidity Index (2.0 vs 1.0; P < .001), and had an American Society of Anesthesiologists score of III to IV more frequently (41% vs 19.9%; P < .001) than normotensive patients. Nonadjusted analysis demonstrated that hypertensive patients had longer operative time (115.0 vs 103.5 minutes; P = .026), higher rate of vasopressors at skin closure (19.7% vs 15.4%; P = .013), more perioperative blood transfusions (7.7% vs 5.0%; P = .016), and an increased complication rate (21.6% vs 17.7%; P = .029). However, after 1:1 PSM, we found that readmission, complications, and serious complications were similar between cohorts. Conclusion: Patients with hypertensive pheochromocytomas have a higher risk of postoperative complications than normotensive patients due to the association of hypertension with a higher burden of comorbidities and older age. However, hypertension is not an independent risk factor of postoperative complications after pheochromocytoma surgery.

KW - Clavin-Dindo

KW - hypertensive

KW - normotensive

KW - pheochromocytoma

KW - surgical outcomes

KW - Clavin-Dindo

KW - hypertensive

KW - normotensive

KW - pheochromocytoma

KW - surgical outcomes

UR - https://publicatt.unicatt.it/handle/10807/322154

U2 - 10.1210/clinem/dgaf154

DO - 10.1210/clinem/dgaf154

M3 - Article

SN - 0021-972X

SP - 1

EP - 11

JO - Journal of Clinical Endocrinology and Metabolism

JF - Journal of Clinical Endocrinology and Metabolism

IS - may 26

ER -

Postoperative outcomes in normotensive and hypertensive pheochromocytomas: an international study

Abstract

Keywords

OSS delle Nazioni Unite

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