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. 2025 Apr 25;25(1):179.
doi: 10.1186/s12893-025-02824-w.

Predictors of postoperative recurrence of pheochromocytoma: a monocentric study

Zhuoran Li #  1 , Dong Lai #  2 , Yuqi Jia #  1 , Jin Luo  1 , Xin Ma  2 , Xu Zhang  2 , Lu Tang  3 , Xintao Li  4 , Baojun Wang  5
Affiliations

Predictors of postoperative recurrence of pheochromocytoma: a monocentric study

Zhuoran Li et al. BMC Surg. .

Abstract

Objective: To discuss the risk factors affecting the recurrence of pheochromocytoma (PCC) following surgery.

Methods: We retrospectively reviewed patients who were hospitalized and underwent surgery for PCC between January 2012 and December 2020 at Chinese People's Liberation Army (PLA) General Hospital. Inclusion criteria were pathological diagnosis of PCC and availability of follow up.

Results: In total, 451 patients met the inclusion criteria. The average age was 45.89 years, and the median tumor diameter was 5.75 cm. The mean recurrence time was 34.24 months. Of the 451 patients receiving surgery, there were 35 recurrent cases (7.85%). The univariate test showed that age, hypertension, history of PCC recurrence, Ki-67 index ≥ 5, bilateral tumor, duration of phenazopyridine administration, DBP at admission, open operation, intraoperative HR minimum, the number of episodes of intraoperative HR over 120 bpm, the number of episodes of intraoperative hemodynamic instability, and intraoperative bleeding were associated with recurrence after surgery. Multivariate COX regression analysis of age (hazard ratio 0.95), hypertension (hazard ratio 7.14), history of PCC recurrence (hazard ratio 69.35), family history of hypertension (hazard ratio 16.30), bilateral tumor (hazard ratio 7.38), tumor size (hazard ratio 1.05), the number of episodes of hemodynamic instability (hazard ratio 114.91) and duration of intraoperative instability (hazard ratio 1.12) were the independent risk factors on recurrence following surgery.

Conclusions: Age, hypertension, history of PCC recurrence, family history of hypertension, bilateral tumor, tumor size, the number of episodes and the duration of intraoperative hemodynamic instability were independent risk factors on recurrence following surgery.

Clinical trial number: Not applicable.

Keywords: Epidemiology; Pheochromocytoma; Recurrence; Risk factors.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The creation and retrospective review of our database was approved by ethics committee of Chinese PLA General Hospital, China, and, therefore, conforms to the ethical standards laid down in the 1964 Helsinki Declaration and its later amendments. This article does not contain any studies with animals performed by any of the authors. Informed consent was obtained from all individual participants included in the study. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
K-M Survival Analysis (A. significant differences in survival curves for age (< 41.5 years) (p = 0.0003); B. significant differences in survival curves for hypertension as a comorbidity(p = 0.014); C. significant differences in survival curves for previous history of recurrence (p < 0.0001); D. no significant differences in survival curves for family history of hypertension (p = 0.2); E. significant differences in survival curves for bilateral tumors (p = 0.0037); F. significant differences in survival curves for tumor size (≥ 11.25 cm) (p = 0.0032); G. significant differences in survival curves for the number of episodes of intraoperative hemodynamic instability ≥ 8 (p = 0.013); H. no significant differences in survival curves for instability minutes (≥ 12.5 min) (p = 0.33))
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