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• W4234801123 abstract "You have accessJournal of UrologyAdrenal (MP69)1 Apr 2019MP69-07 LONG-TERM FUNCTIONAL AND ONCOLOGIC OUTCOMES OF PARTIAL ADRENALECTOMY FOR PHEOCHROMOCYTOMA Patrick T. Gomella*, Peter A. Pinto, Adam R. Metwalli, Gennady Bratslavsky, W. Marston Linehan, and Mark W. Ball Patrick T. Gomella*Patrick T. Gomella* More articles by this author , Peter A. PintoPeter A. Pinto More articles by this author , Adam R. MetwalliAdam R. Metwalli More articles by this author , Gennady BratslavskyGennady Bratslavsky More articles by this author , W. Marston LinehanW. Marston Linehan More articles by this author , and Mark W. BallMark W. Ball More articles by this author View All Author Informationhttps://doi.org/10.1097/01.JU.0000557584.16942.0bAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVES: The safety and feasibility of partial adrenalectomy has been established, however long-term outcome data is limited. In this study we evaluate the recurrence and functional outcomes in a primarily hereditary cohort of patients undergoing partial adrenalectomy for pheochromocytoma. METHODS: A retrospective review from a prospectively managed database of patients undergoing partial adrenalectomy from 1995-2018 at the National Cancer Institute was performed. Demographics, hereditary syndrome status, surgical indication, recurrence and steroid replacement status data were collected. Local recurrence was defined as imaging evidence of a recurrent or de novo lesion on the operative side. Steroid dependency was defined as requiring daily steroid replacement at time of last follow-up. RESULTS: A total of 123 partial adrenalectomies, removing 161 tumors, were performed in 106 patients. The majority of patients had a known hereditary predisposition to develop bilateral, multifocal and recurrent pheochromocytoma, with VHL being the most common (83, 78.3 %). The majority of patients presented with symptoms suggestive of pheochromocytoma and/or elevated catecholamines. Median tumor size was found to be 2cm (IQR 1.5-2.8). Median follow-up in this cohort was 60 months (IQR 13-131). Local recurrence occurred in 17 patients (16%) and was managed with active surveillance or surgery. Median time to recurrence was 71 months (IQR 26-127). A single patient (1/106, 0.9%) developed metastatic spread of pheochromocytoma (bone and lung) approximately 14 years after his first of 2 partial adrenalectomies and remains alive under active surveillance. 10 patients (9.4%) were on daily steroid replacement at time of last follow-up. Five patients experienced a complication of ≥3 on the Clavien-dindo scale (4.1%). Three of these patients underwent concurrent surgery at the time of partial adrenalectomy (1 partial nephrectomy and 2 pancreas resections). CONCLUSIONS: Partial adrenalectomy offers excellent oncologic and functional outcomes, sparing most patients from lifelong steroid replacement therapy. Recurrences can be easily managed with repeat surgery or active surveillance via functional work-up and imaging. Partial adrenalectomy remains the recommended surgical management for patients pre-disposed to development of bilateral, multifocal and recurrent pheochromocytoma. Source of Funding: This research was supported by the Intramural Research Program of the NIH, National Cancer Institute, Center for Cancer Research. Bethesda, MD© 2019 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 201Issue Supplement 4April 2019Page: e986-e986 Advertisement Copyright & Permissions© 2019 by American Urological Association Education and Research, Inc.MetricsAuthor Information Patrick T. Gomella* More articles by this author Peter A. Pinto More articles by this author Adam R. Metwalli More articles by this author Gennady Bratslavsky More articles by this author W. Marston Linehan More articles by this author Mark W. Ball More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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• W4234801123 title "MP69-07 LONG-TERM FUNCTIONAL AND ONCOLOGIC OUTCOMES OF PARTIAL ADRENALECTOMY FOR PHEOCHROMOCYTOMA" @default.
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