Dahl Måns A J, Calissendorff Jan, Falhammar Henrik
Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
Department of Endocrinology, Karolinska University Hospital, Stockholm, Sweden.
Front Endocrinol (Lausanne). 2025 Jun 16;16:1597908. doi: 10.3389/fendo.2025.1597908. eCollection 2025.
The aim of this study was to investigate sex differences in the management and outcomes of patients with pheochromocytomas and paragangliomas (PPGLs).
This is a retrospective cohort study including all patients diagnosed with PPGLs attending the Department of Endocrinology at Karolinska University Hospital between June 2005 and August 2024. The collected data included patient characteristics, biochemical, genetical, pharmacological and vital parameters noted during initial PPGL presentation and during follow-up, including survival.
In total, 196 patients diagnosed with PPGLs (108 females and 88 males) were included. Paragangliomas were more prevalent in females than in males (23.1% vs 11.4%, P=0.04). Females required a lower final dose of preoperative phenoxybenzamine (50.8 ± 19.8 vs 87.5 ± 75.7 mg, P=0.04), while the final dose of preoperative doxazosin was non-significant lower (22.3 ± 13.6 vs 26.0 ± 13.9 mg, P=0.07). Moreover, females were less likely having laparoscopic surgery than males (55.2% vs 71.1%, P=0.03). After surgery, more females achieved remission from their type 2 diabetes compared to males (23.4% vs 11.8%, P=0.04). Despite similar age at diagnosis and similar follow-up time, no sex differences were identified in metastasis risk, blood pressure outcomes after surgery, or survival.
Females presented more often with paragangliomas which may explain why they were less likely to have laparoscopic surgery. Remission of type 2 diabetes occurred more commonly in females after surgery. Most other outcomes were similar between sexes. More research is needed to explore differences in outcomes between sexes in PPGLs.
本研究旨在调查嗜铬细胞瘤和副神经节瘤（PPGLs）患者在治疗及预后方面的性别差异。
这是一项回顾性队列研究，纳入了2005年6月至2024年8月期间在卡罗林斯卡大学医院内分泌科就诊的所有诊断为PPGLs的患者。收集的数据包括患者特征、初次诊断PPGLs时及随访期间记录的生化、遗传、药理和生命参数，包括生存情况。
总共纳入了196例诊断为PPGLs的患者（108例女性和88例男性）。副神经节瘤在女性中比男性更常见（23.1%对11.4%，P = 0.04）。女性术前苯氧苄胺的最终剂量较低（50.8±19.8对87.5±75.7毫克，P = 0.04），而术前多沙唑嗪的最终剂量虽较低但无统计学意义（22.3±13.6对26.0±13.9毫克，P = 0.07）。此外，女性接受腹腔镜手术的可能性低于男性（55.2%对71.1%，P = 0.03）。术后，与男性相比，更多女性的2型糖尿病得到缓解（23.4%对11.8%，P = 0.04）。尽管诊断时年龄和随访时间相似，但在转移风险、术后血压结果或生存方面未发现性别差异。
女性更常表现为副神经节瘤，这可能解释了她们接受腹腔镜手术的可能性较低的原因。术后2型糖尿病缓解在女性中更常见。大多数其他结果在性别之间相似。需要更多研究来探索PPGLs患者性别之间的预后差异。
