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This Article Accepted manuscript (PDF) All Versions of this Article: ERC-08-0049v1 15/4/1127    most recent Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Timmers, H J L M Articles by Lenders, J W M Search for Related Content PubMed PubMed Citation Articles by Timmers, H J L M Articles by Lenders, J W M

H Timmers, Department of Endocrinology (741), Radboud University Nijmegen Medical Center, Nijmegen, Netherlands
F Brouwers, General Internal Medicine, Radboud University Nijmegen Medical Center, Nijmegen, 6500 HB , Netherlands
A Hermus, Department of Endocrinology (741), Radboud University Nijmegen Medical Center, Nijmegen, Netherlands
F Sweep, Chemical Endocrinology, Radboud University Nijmegen Medical Center, Nijmegen, Netherlands
A Verhofstad, Pathology, Radboud University Nijmegen Medical Center, Nijmegen, Netherlands
A Verbeek, Epidemiology and Biostatistics, Radboud University Nijmegen Medical Center, Nijmegen, Netherlands
K Pacak, RBMB, NIH, Bethesda, United States
J Lenders, Internal medicine, UMC Radboud Nijmegen, Nijmegen, Netherlands

Correspondence: F M Brouwers, Email: z125135_fmb{at}hotmail.com

Abstract

The treatment of choice for non-metastatic pheochromocytoma is surgical resection. Its goals are to abolish catecholamine hypersecretion, normalize blood pressure, and prevent further tumor growth or progression to metastatic disease. Data on long-term mortality and morbidity after pheochromocytoma surgery are limited. We here report a retrospective study on the long-term outcome after surgery for apparently benign pheochromocytoma at the Radboud University Nijmegen Medical Centre. Data on clinical presentation, treatment, post surgical blood pressure and recurrence, metastasis and death were collected of 69 consecutive patients (January 1966-December 2000; follow-up: until death or January 2006). Survival was compared to survival of a matched reference population. Two patients died of surgical complications. All ten patients with metastatic disease (including 3 diagnosed at first surgery) died. At follow-up, forty patients were alive and recurrence free, and 3 patients were lost to follow up. Two patients experienced a benign recurrence. Mean ± SD follow-up was 10.2±7.5 (median 9.0, range 1-38) years. Kaplan-Meier estimates for 5- and 10-year survival since surgery were 85.8% [95% CI: 77.2-94.4%] and 74.2% [95% CI: 62.0-86.4%] for patients versus 95.5 and 89.4% in the reference population (P<0.05). Sixty-four percent of all patients with hypertension prior to surgery showed a significant decrease in blood pressure, but remained hypertensive after surgery. In conclusion, compared to the general population patients have a reduced life expectancy following pheochromocytoma surgery, due to their risk of developing metastatic disease. Only one third becomes normotensive without antihypertensive medication. Therefore, life-long follow-up is warranted.