Clinical Presentation and Perioperative Management of Pheochromocytomas and Paragangliomas: A 4-Decade Experience

Simple item page
dc.catalogadorvzp
dc.contributor.authorUslar, Thomas
dc.contributor.authorSan Francisco, Ignacio F.
dc.contributor.authorOlmos, Roberto
dc.contributor.authorMacchiavelo, Stefano
dc.contributor.authorZuniga, Alvaro
dc.contributor.authorRojas, Pablo
dc.contributor.authorGarrido, Marcelo
dc.contributor.authorHuete, Alvaro
dc.contributor.authorMendez, Gonzalo P.
dc.contributor.authorCortinez, Ignacio
dc.contributor.authorZemelman, Jose Tomas
dc.contributor.authorCifuentes, Joaquin
dc.contributor.authorCastro, Fernando
dc.contributor.authorOlivari, Daniela
dc.contributor.authorDominguez, Jose Miguel
dc.contributor.authorArteaga, Eugenio
dc.contributor.authorFardella, Carlos E.
dc.contributor.authorValdes, Gloria
dc.contributor.authorTagle, Rodrigo
dc.contributor.authorBaudrand, Rene
dc.date.accessioned2024-05-31T13:40:24Z
dc.date.available2024-05-31T13:40:24Z
dc.date.issued2021
dc.description.abstractPurpose: Latin American reports on pheochromocytomas and paragangliomas (PPGLs) are scarce. Recent studies demonstrate changes in clinical presentation and management of these patients. Herein, we assessed the main characteristics of PPGL patients in our academic center over the past 4 decades.
dc.description.abstractMethods: Demographic, clinical, biochemical, and perioperative data from 105 PPGL patients were retrospectively and prospectively collected over the 1980-2019 period. Data were organized into 4 periods by decade.
dc.description.abstractResults: Age at diagnosis, gender, tumor size and percentage of bilaterality, percentage of paragangliomas, and metastases remained stable across the 4 decades. The proportion of genetic testing and incidentalomas increased in recent decades (all P < 0.001). Therefore, we compared PPGLs diagnosed as incidentalomas (36%) with those clinically suspected (64%). Incidentalomas had fewer adrenergic symptoms (38 vs. 62%; P< 0.001) and lower rates of hypertension (64% vs. 80%; P = 0.01) and hypertensive crisis (28% vs. 44%; P= 0.02); also, they had lower functionality (79% vs. 100%; P= 0.01) and lower catecholamines levels (8.4-fold vs. 12.5-fold above upper cutoffs; P = 0.04). Regarding management of all PPGLs over the decades, we observed significant increases in both perioperative doxazosin dose (P = 0.003) and laparoscopic approach rates (P < 0.001), along with a decrease in the length of hospital stays (P= 0.007).
dc.description.abstractConclusions: We observed a change in the clinical presentation of PPGL in recent decades, with a marked increase in incidental cases and milder symptoms.The implementation of a multidisciplinary program for adrenal disorders in our institution has translated into more timely diagnoses, more genetic testing, and improvements in perioperative management.
dc.format.extent7 páginas
dc.fuente.origenORCID
dc.identifier.doi10.1210/jendso/bvab073
dc.identifier.eissn2472-1972
dc.identifier.urihttps://doi.org/10.1210/jendso/bvab073
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/86158
dc.identifier.wosidWOS:000692580300003
dc.information.autorucEscuela de Medicina; Baudrand Biggs, Rene Felipe; 0000-0002-8655-4957; 1026
dc.issue.numero10
dc.language.isoen
dc.nota.accesocontenido parcial
dc.publisherENDOCRINE SOC
dc.revistaJournal of the Endocrine Society
dc.rightsacceso restringido
dc.subjectpheochromocytoma
dc.subjectparaganglioma
dc.subjectincidentaloma
dc.subjectPPGL
dc.subjectclinical presentation
dc.subjectneuroendocrine
dc.subjectNATIONWIDE
dc.subjectPROGNOSIS
dc.subjectFEATURES
dc.subject.ddc610
dc.subject.deweyMedicina y saludes_ES
dc.titleClinical Presentation and Perioperative Management of Pheochromocytomas and Paragangliomas: A 4-Decade Experience
dc.typeartículo
dc.volumen5
sipa.codpersvinculados1024
sipa.trazabilidadORCID;2024-05-27
Files
Collections
Artículos de revistas