Department of Urology, Shengjing Hospital of China Medical University, Shenyang, China.
J Surg Oncol. 2024 Sep;130(3):380-385. doi: 10.1002/jso.27764. Epub 2024 Jul 31.
Surgical resection is the primary management for pheochromocytoma. However, some patients with pheochromocytoma still suffer from hypertension after successful adrenalectomy. The risk factors for postoperative persistent hypertension remain unclear. Thus the aim of the present study was to identify the risk factors of postoperative persistent hypertension in patients with pheochromocytoma concomitant with hypertension.
We retrospectively analyzed 259 patients with pheochromocytoma who underwent adrenalectomy in our hospital between January 1, 2007, and December 31, 2018. Patients' demographics, comorbidities, and perioperative data were recorded. The odds ratio (OR) and 95% confidence interval were measured through binary logistic regression. The cutoff values and the area under the curve (AUC) for continuous risk factors of persistent hypertension after adrenalectomy were calculated through receiver operating characteristic curve analysis.
Of the 259 patients, 40.9% (106/259) patients experienced postoperative persistent hypertension. Three independent risk factors of persistent hypertension in patients with pheochromocytoma after adrenalectomy were found to be older age (OR = 1.16, p = 0.037), longer duration of hypertension (OR = 3.10, p = 0.01), and concomitance with cardiovascular events (yes vs. no, OR = 17.17, p = 0.049). The cutoff value of age and duration of hypertension was 66 years (AUC = 0.741, p < 0.0001) and 27 months (AUC = 0.991, p < 0.0001), respectively.
Collectively, older age, a longer duration of hypertension, and concomitance with cardiovascular events were independent risk factors of persistent hypertension in patients with pheochromocytoma after adrenalectomy. These findings may help in improving perioperative management and follow-up strategies.
手术切除是治疗嗜铬细胞瘤的主要方法。然而，一些成功接受肾上腺切除术的嗜铬细胞瘤患者仍患有高血压。术后持续性高血压的危险因素尚不清楚。因此，本研究旨在确定伴有高血压的嗜铬细胞瘤患者术后持续性高血压的危险因素。
我们回顾性分析了 2007 年 1 月 1 日至 2018 年 12 月 31 日期间在我院接受肾上腺切除术的 259 例嗜铬细胞瘤患者。记录患者的人口统计学、合并症和围手术期数据。通过二项逻辑回归测量比值比（OR）和 95%置信区间。通过接收者操作特征曲线分析计算连续风险因素术后持续性高血压的截断值和曲线下面积（AUC）。
在 259 例患者中，40.9%（106/259）患者术后发生持续性高血压。发现 3 个与嗜铬细胞瘤患者术后持续性高血压相关的独立危险因素，分别为年龄较大（OR=1.16，p=0.037）、高血压持续时间较长（OR=3.10，p=0.01）和合并心血管事件（是 vs. 否，OR=17.17，p=0.049）。年龄和高血压持续时间的截断值分别为 66 岁（AUC=0.741，p<0.0001）和 27 个月（AUC=0.991，p<0.0001）。
综上所述，年龄较大、高血压持续时间较长以及合并心血管事件是嗜铬细胞瘤患者术后持续性高血压的独立危险因素。这些发现可能有助于改善围手术期管理和随访策略。
