Abstract:

Objective  To explore the differences of intraoperative conditions and prognosis between patients with primary malignant pheochromocytomas (pheos) and recurrent malignant pheos. Methods  A total of 284 cases of pheos were retrospectively analyzed and 32 cases that were pathologically diagnosed with biological malignance or metastasis were included in the study and divided into the primary malignant pheos group (n=17) and recurrent malignant pheos group (n=15). Baseline characteristics, intraoperative conditions, and prognosis of two groups were compared and analyzed. Results  Compared with patients pathologically diagnosed with metastasis, baseline characteristics of patients pathologically diagnosed with biological malignance were similar, while the prognosis was much better (P=0.015). The risk of surrounding organs excision and debulking surgery of patients with recurrent malignant pheos was significantly higher than that of patients with primary malignant pheos (P=0.023, P=0.016). Results of postoperative follow-ups showed that the prognosis of patients with recurrent malignant pheos was significantly worse than that of patients with primary malignant pheos (P=0.029, P=0.025) and the prognosis was not significantly correlated with biological malignance or metastasis. Conclusion  Surgical removal is still the main treatment for malignant pheos. Compared with patients with primary malignant pheos, the operation risk of patients with recurrent malignant pheos increases and the prognosis is worse.

Key words: pheochromocytoma, malignance, diagnosis, treatment, prognosis