Outcomes of patients with metastatic phaeochromocytoma and paraganglioma: A systematic review and meta-analysis

Oksana Hamidi, William F. Young, Lucinda Gruber, John Smestad, Qi Yan, Oscar J. Ponce, Larry Prokop, Mohammad Hassan Murad, Irina Bancos

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Objective: The outcomes of patients with metastatic phaeochromocytoma (PHEO) and paraganglioma (PGL) are unclear. We performed a systematic review and meta-analysis of baseline characteristics and mortality rates of patients with metastatic PHEO and PGL (PPGL). Design: Ovid MEDLINE In-Process & Other Non-Indexed Citations, Ovid MEDLINE, Ovid EMBASE, Ovid Cochrane Central Register of Controlled Trials, Ovid Cochrane Database of Systematic Reviews, Scopus, Web of Science, and references of key articles were searched from inception to 2016. Patients: Studies comprised ≥20 patients with metastatic PPGL and reported baseline characteristics and follow-up data. Measurements: Reviewers extracted standardized data and assessed risk of bias using a modified Newcastle-Ottawa tool. Random-effects meta-analysis was used to pool event rates across studies. Results: Twenty retrospective noncomparative studies reported on 1338 patients with metastatic PHEO (685/1296, 52.9%) and PGL (611/1296, 47.1%), diagnosed at a mean age of 43.9 ± 5.2 years. Mean follow-up was 6.3 ± 3.2 years. Of 532 patients with reported data, 40.4% had synchronous metastases. Five-year (7 studies, n = 738) and 10-year (2 studies, n = 55) mortality rates for patients with metastatic PPGL were 37% (95% CI, 24%-51%) and 29% (95% CI, 17%-42%), respectively. Higher mortality was associated with male sex (RR 1.50; 95% CI, 1.11-2.02) and synchronous metastases (RR 2.43; 95% CI, 1.01-5.85). Conclusions: Available low-quality evidence from heterogeneous studies suggests low mortality rates of patients with metastatic PPGL. Male sex and synchronous metastases correlated with increased mortality. The outcomes of patients with metastatic PPGL have been inadequately assessed, indicating the need for carefully planned prospective studies.

Original languageEnglish (US)
Pages (from-to)440-450
Number of pages11
JournalClinical Endocrinology
Volume87
Issue number5
DOIs
StatePublished - Nov 2017
Externally publishedYes

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Paraganglioma
Pheochromocytoma
Meta-Analysis
Mortality
Neoplasm Metastasis
MEDLINE
Retrospective Studies
Databases
Prospective Studies

Keywords

  • mortality
  • neoplasm metastasis
  • paraganglioma
  • phaeochromocytoma
  • succinate dehydrogenase

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

Cite this

Outcomes of patients with metastatic phaeochromocytoma and paraganglioma : A systematic review and meta-analysis. / Hamidi, Oksana; Young, William F.; Gruber, Lucinda; Smestad, John; Yan, Qi; Ponce, Oscar J.; Prokop, Larry; Murad, Mohammad Hassan; Bancos, Irina.

In: Clinical Endocrinology, Vol. 87, No. 5, 11.2017, p. 440-450.

Research output: Contribution to journalArticle

Hamidi, O, Young, WF, Gruber, L, Smestad, J, Yan, Q, Ponce, OJ, Prokop, L, Murad, MH & Bancos, I 2017, 'Outcomes of patients with metastatic phaeochromocytoma and paraganglioma: A systematic review and meta-analysis', Clinical Endocrinology, vol. 87, no. 5, pp. 440-450. https://doi.org/10.1111/cen.13434
Hamidi, Oksana ; Young, William F. ; Gruber, Lucinda ; Smestad, John ; Yan, Qi ; Ponce, Oscar J. ; Prokop, Larry ; Murad, Mohammad Hassan ; Bancos, Irina. / Outcomes of patients with metastatic phaeochromocytoma and paraganglioma : A systematic review and meta-analysis. In: Clinical Endocrinology. 2017 ; Vol. 87, No. 5. pp. 440-450.
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title = "Outcomes of patients with metastatic phaeochromocytoma and paraganglioma: A systematic review and meta-analysis",
abstract = "Objective: The outcomes of patients with metastatic phaeochromocytoma (PHEO) and paraganglioma (PGL) are unclear. We performed a systematic review and meta-analysis of baseline characteristics and mortality rates of patients with metastatic PHEO and PGL (PPGL). Design: Ovid MEDLINE In-Process & Other Non-Indexed Citations, Ovid MEDLINE, Ovid EMBASE, Ovid Cochrane Central Register of Controlled Trials, Ovid Cochrane Database of Systematic Reviews, Scopus, Web of Science, and references of key articles were searched from inception to 2016. Patients: Studies comprised ≥20 patients with metastatic PPGL and reported baseline characteristics and follow-up data. Measurements: Reviewers extracted standardized data and assessed risk of bias using a modified Newcastle-Ottawa tool. Random-effects meta-analysis was used to pool event rates across studies. Results: Twenty retrospective noncomparative studies reported on 1338 patients with metastatic PHEO (685/1296, 52.9{\%}) and PGL (611/1296, 47.1{\%}), diagnosed at a mean age of 43.9 ± 5.2 years. Mean follow-up was 6.3 ± 3.2 years. Of 532 patients with reported data, 40.4{\%} had synchronous metastases. Five-year (7 studies, n = 738) and 10-year (2 studies, n = 55) mortality rates for patients with metastatic PPGL were 37{\%} (95{\%} CI, 24{\%}-51{\%}) and 29{\%} (95{\%} CI, 17{\%}-42{\%}), respectively. Higher mortality was associated with male sex (RR 1.50; 95{\%} CI, 1.11-2.02) and synchronous metastases (RR 2.43; 95{\%} CI, 1.01-5.85). Conclusions: Available low-quality evidence from heterogeneous studies suggests low mortality rates of patients with metastatic PPGL. Male sex and synchronous metastases correlated with increased mortality. The outcomes of patients with metastatic PPGL have been inadequately assessed, indicating the need for carefully planned prospective studies.",
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AU - Hamidi, Oksana

AU - Young, William F.

AU - Gruber, Lucinda

AU - Smestad, John

AU - Yan, Qi

AU - Ponce, Oscar J.

AU - Prokop, Larry

AU - Murad, Mohammad Hassan

AU - Bancos, Irina

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N2 - Objective: The outcomes of patients with metastatic phaeochromocytoma (PHEO) and paraganglioma (PGL) are unclear. We performed a systematic review and meta-analysis of baseline characteristics and mortality rates of patients with metastatic PHEO and PGL (PPGL). Design: Ovid MEDLINE In-Process & Other Non-Indexed Citations, Ovid MEDLINE, Ovid EMBASE, Ovid Cochrane Central Register of Controlled Trials, Ovid Cochrane Database of Systematic Reviews, Scopus, Web of Science, and references of key articles were searched from inception to 2016. Patients: Studies comprised ≥20 patients with metastatic PPGL and reported baseline characteristics and follow-up data. Measurements: Reviewers extracted standardized data and assessed risk of bias using a modified Newcastle-Ottawa tool. Random-effects meta-analysis was used to pool event rates across studies. Results: Twenty retrospective noncomparative studies reported on 1338 patients with metastatic PHEO (685/1296, 52.9%) and PGL (611/1296, 47.1%), diagnosed at a mean age of 43.9 ± 5.2 years. Mean follow-up was 6.3 ± 3.2 years. Of 532 patients with reported data, 40.4% had synchronous metastases. Five-year (7 studies, n = 738) and 10-year (2 studies, n = 55) mortality rates for patients with metastatic PPGL were 37% (95% CI, 24%-51%) and 29% (95% CI, 17%-42%), respectively. Higher mortality was associated with male sex (RR 1.50; 95% CI, 1.11-2.02) and synchronous metastases (RR 2.43; 95% CI, 1.01-5.85). Conclusions: Available low-quality evidence from heterogeneous studies suggests low mortality rates of patients with metastatic PPGL. Male sex and synchronous metastases correlated with increased mortality. The outcomes of patients with metastatic PPGL have been inadequately assessed, indicating the need for carefully planned prospective studies.

AB - Objective: The outcomes of patients with metastatic phaeochromocytoma (PHEO) and paraganglioma (PGL) are unclear. We performed a systematic review and meta-analysis of baseline characteristics and mortality rates of patients with metastatic PHEO and PGL (PPGL). Design: Ovid MEDLINE In-Process & Other Non-Indexed Citations, Ovid MEDLINE, Ovid EMBASE, Ovid Cochrane Central Register of Controlled Trials, Ovid Cochrane Database of Systematic Reviews, Scopus, Web of Science, and references of key articles were searched from inception to 2016. Patients: Studies comprised ≥20 patients with metastatic PPGL and reported baseline characteristics and follow-up data. Measurements: Reviewers extracted standardized data and assessed risk of bias using a modified Newcastle-Ottawa tool. Random-effects meta-analysis was used to pool event rates across studies. Results: Twenty retrospective noncomparative studies reported on 1338 patients with metastatic PHEO (685/1296, 52.9%) and PGL (611/1296, 47.1%), diagnosed at a mean age of 43.9 ± 5.2 years. Mean follow-up was 6.3 ± 3.2 years. Of 532 patients with reported data, 40.4% had synchronous metastases. Five-year (7 studies, n = 738) and 10-year (2 studies, n = 55) mortality rates for patients with metastatic PPGL were 37% (95% CI, 24%-51%) and 29% (95% CI, 17%-42%), respectively. Higher mortality was associated with male sex (RR 1.50; 95% CI, 1.11-2.02) and synchronous metastases (RR 2.43; 95% CI, 1.01-5.85). Conclusions: Available low-quality evidence from heterogeneous studies suggests low mortality rates of patients with metastatic PPGL. Male sex and synchronous metastases correlated with increased mortality. The outcomes of patients with metastatic PPGL have been inadequately assessed, indicating the need for carefully planned prospective studies.

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KW - phaeochromocytoma

KW - succinate dehydrogenase

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