TY - JOUR
T1 - Changes in clinical features and long-term prognosis in patients with pheochromocytoma
AU - Noshiro, Takao
AU - Shimizu, Kazumasa
AU - Watanabe, Toshiya
AU - Akama, Hiroyoshi
AU - Shibukawa, Satoru
AU - Miura, Wakako
AU - Ito, Sadayoshi
AU - Miura, Yukio
N1 - Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2000
Y1 - 2000
N2 - To investigate changes in preoperative clinical features and the long-term outcome of tumor recurrence, mortality, and morbidity in patients with pheochromocytoma, we retrospectively examined changes in the clinical features by comparing 49 patients from 1957 to 1985 (group I) with 46 patients from 1986 to December 1995 (group II). In addition in these 95 patients (excluding 2 who had died before operation), we evaluated long-term postoperative outcome from the initial operation to August 1996 (909 patient-years). The mean age in group II was older than that of group I. The percentage of patients having proteinuria or hypertensive retinopathy in group II was less than that in group I. Of 20 patients with incidentally discovered pheochromocytoma, 7 (35%) were ≥60 years old, 7 asymptomatic, and 11 (55%) normotensive. Plasma and urinary catecholamines in these patients were significantly (P < .01) lower than in patients with pheochromocytoma having typical clinical features. Long-term cohort study showed 14 deaths. Relative survival rates were 91% at 5 years and 83% at 10 years and unchanged thereafter. The Kaplan-Meier estimate of pheochromocytoma-free survival was shorter in patients with a larger-than-median (60 g) tumor weight. Six patients had malignant recurrence 3 to 101 months (median, 45 months) after the initial operation. Of 65 patients confirmed alive at follow-up, 11 were hypertensive. In the Cox model, hypertension-free survival was not associated with age, a family history of hypertension, duration of hypertension, or creatinine clearance. Pheochromocytoma should be diagnosed from a wide spectrum of clinical features including those that are not generally suspected of resulting from excess catecholamines or hypertension, and after surgery, patients with this disease should be followed-up carefully for a long period (at least 10 years) because of the risk of tumor recurrence and the high prevalence of disease.
AB - To investigate changes in preoperative clinical features and the long-term outcome of tumor recurrence, mortality, and morbidity in patients with pheochromocytoma, we retrospectively examined changes in the clinical features by comparing 49 patients from 1957 to 1985 (group I) with 46 patients from 1986 to December 1995 (group II). In addition in these 95 patients (excluding 2 who had died before operation), we evaluated long-term postoperative outcome from the initial operation to August 1996 (909 patient-years). The mean age in group II was older than that of group I. The percentage of patients having proteinuria or hypertensive retinopathy in group II was less than that in group I. Of 20 patients with incidentally discovered pheochromocytoma, 7 (35%) were ≥60 years old, 7 asymptomatic, and 11 (55%) normotensive. Plasma and urinary catecholamines in these patients were significantly (P < .01) lower than in patients with pheochromocytoma having typical clinical features. Long-term cohort study showed 14 deaths. Relative survival rates were 91% at 5 years and 83% at 10 years and unchanged thereafter. The Kaplan-Meier estimate of pheochromocytoma-free survival was shorter in patients with a larger-than-median (60 g) tumor weight. Six patients had malignant recurrence 3 to 101 months (median, 45 months) after the initial operation. Of 65 patients confirmed alive at follow-up, 11 were hypertensive. In the Cox model, hypertension-free survival was not associated with age, a family history of hypertension, duration of hypertension, or creatinine clearance. Pheochromocytoma should be diagnosed from a wide spectrum of clinical features including those that are not generally suspected of resulting from excess catecholamines or hypertension, and after surgery, patients with this disease should be followed-up carefully for a long period (at least 10 years) because of the risk of tumor recurrence and the high prevalence of disease.
KW - Catecholamine
KW - Hypertension
KW - Multiple endocrine neoplasia type 2A
KW - Pheochromocytoma
KW - Recurrence
UR - http://www.scopus.com/inward/record.url?scp=0033980581&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0033980581&partnerID=8YFLogxK
U2 - 10.1016/s0895-7061(99)00139-9
DO - 10.1016/s0895-7061(99)00139-9
M3 - Article
C2 - 10678269
AN - SCOPUS:0033980581
VL - 13
SP - 35
EP - 43
JO - American Journal of Hypertension
JF - American Journal of Hypertension
SN - 0895-7061
IS - 1 II SUPPL.
ER -