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The role of the adrenalectomy in the management of pheochromocytoma: the experience of a Portuguese referral center

Title
The role of the adrenalectomy in the management of pheochromocytoma: the experience of a Portuguese referral center
Type
Article in International Scientific Journal
Year
2024
Authors
Carvalho, IC
(Author)
Other
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Machado, MVB
(Author)
Other
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Morais, JP
(Author)
Other
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carvalho, f
(Author)
FMUP
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Barbosa, E
(Author)
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José Barbosa
(Author)
FMUP
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Journal
Title: EndocrineImported from Authenticus Search for Journal Publications
Vol. 86
Pages: 409-416
ISSN: 0969-711X
Publisher: Springer Nature
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Publicação em ISI Web of Knowledge ISI Web of Knowledge - 0 Citations
Publicação em Scopus Scopus - 0 Citations
Other information
Authenticus ID: P-010-HAY
Abstract (EN): Purpose Pheochromocytoma is a rare neuroendocrine tumor. Despite the low incidence, these tumors are of indisputable importance. This study aimed to analyze the management of pheochromocytoma in a referral center, with an emphasis on the minimally invasive adrenalectomy, which is the preferred therapeutic approach. Methods A retrospective analysis was performed on a cohort of patients diagnosed with pheochromocytoma who underwent adrenalectomy between January 2013 and December 2022. Clinical data including demographics, timelines, symptomatology, comorbidities, biochemical markers, genetic testing, surgical details, and follow-up outcomes, were collected and analyzed. Results The cohort included 44 patients, predominantly women (52.27%), with a median age of 53.39 years (range 13-83). Most of patients exhibited paroxysmal symptoms suggesting catecholamine excess. Documented hypertension was the most frequent (86.36%), along with glucose anomalies (40.01%) and anxiety disorder (31.82%). Genetic testing was performed in 36 (81.81%) patients and 14 (38.88%) revealed a positive result, predominantly RET pathogenic variant. Laparoscopic surgery was performed in 34 (79.07%) patients, showing significantly shorter operative time (2.5 h vs. 4.25 h, t-test p < 0,001) and fewer complications (23.53% vs 77.78%, p = 0.008). Postoperative complications occurred in 36.36% of the patients, mostly mild (grade I, 56.25%), with no mortality. SDHB pathogenic variant correlated with both recurrent and metastatic disease (p = 0.006). One-year follow-up reported 9.09% recurrence and 6.82% metastasis. Conclusions Adrenalectomy demonstrated a high safety and effectiveness. This study exhibited a higher rate of genetic testing referral than other studies. Despite past advances, there is still a need for further studies to establish protocols and evaluate new techniques.
Language: English
Type (Professor's evaluation): Scientific
No. of pages: 8
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