FEATURES OF MANAGEMENT AND SURGICAL TREATMENT OF MALIGNANT PHEOCHROMOCYTOMA
Keywords:
pheochromocytoma; treatment of pheochromocytoma; alpha block; preoperative medical preparation; intraoperative hemodynamic instability; minimally invasive surgery; adrenalectomyAbstract
Preoperative preparation with alpha-blockers was introduced in the early 1960s to prevent intraoperative hemodynamic instability and thus reduce mortality in high-risk patients. Indeed, surgery at that time consisted of open adrenalectomies with high morbidity and mortality. Current clinical guidelines are based on this early experience. However, new technologies have dramatically reduced mortality in patients with pheochromocytoma. However, clinical guidelines have not evolved at the same rate.
Treatment of pheochromocytomas has changed significantly over the past 50 years, especially with the advent of new technologies such as laparoscopic procedures in the 1990s. Current clinical guidelines recommend the use of antihypertensive drugs to prevent intraoperative hemodynamic instability and cardiovascular complications. However, these recommendations are still based on previous experience and are the subject of debate in the scientific community.
References
Reisch, N.; Peczkowska, M.; Januszewicz, A.; Neumann, H.P.H. Pheochromocytoma: Presentation, diagnosis and treatment. J. Hypertens. 2006, 24, 2331–2339.(in Russ).
Omura, M.; Saito, J.; Yamaguchi, K.; Kakuta, Y.; Nishikawa, T. Prospective Study on the Prevalence of Secondary Hypertension among Hypertensive Patients Visiting a General Outpatient Clinic in Japan. Hypertens. Res. 2004, 27, 193–202.(in Russ).
Naranjo, J.; Dodd, S.; Martin, Y.N. Perioperative Management of Pheochromocytoma. J. Cardiothorac. Vasc. Anesth. 2017, 31, 1427–1439.(in Russ).
Y-Hassan, S.; Falhammar, H. Cardiovascular manifestations and complications of pheochromocytomas and paragangliomas. J. Clin. Med. 2020, 9, 2435.(in Russ).
Lenders, J.W.M.; Eisenhofer, G. Update on modern management of pheochromocytoma and paraganglioma. Endocrinol. Metab. 2017, 32, 152–161.(in Russ).
Farrugia, F.A.; Martikos, G.; Tzanetis, P.; Charalampopoulos, A.; Misiakos, E.; Zavras, N.; Sotiropoulos, D. Pheochromocytoma, diagnosis and treatment: Review of the literature. Endocr. Regul. 2017, 51, 168–181.(in Russ).
Castinetti, F.; de Freminville, J.B.; Guerin, C.; Cornu, E.; Sarlon, G.; Amar, L. Controversies about the systematic preoperative pharmacological treatment before pheochromocytoma or paraganglioma surgery. Eur. J. Endocrinol. 2022, 168, D17–D24.(in Russ).
Neumann, H.P.H.; Young, W.F.; Eng, C. Pheochromocytoma and Paraganglioma. N. Engl. J. Med. 2019, 381, 552–565.(in Russ).
Young, W.F. Endocrine hypertension: Then and now. Endocr. Pract. 2010, 16, 888–902.(in Russ).
Lenders, J.W.M.; Kerstens, M.N.; Amar, L.; Prejbisz, A.; Robledo, M.; Taieb, D.; Pacak, K.; Crona, J.; Zelinka, T.; Mannelli, M.; et al. Genetics, diagnosis, management and future directions of research of phaeochromocytoma and paraganglioma: A position statement and consensus of the Working Group on Endocrine Hypertension of the European Society of Hypertension. J. Hypertens. 2020, 38, 1443–1456.(in Russ).
Shamseer, L.; Moher, D.; Clarke, M.; Ghersi, D.; Liberati, A.; Petticrew, M.; Shekelle, P.; Stewart, L.A.; PRISMA-P Group. Preferred reporting items for systematic review and meta-analysis protocols (prisma-p) 2015: Elaboration and explanation. BMJ 2015, 350, g7647.(in Russ).
Goossen, K.; Tenckhoff, S.; Probst, P.; Grummich, K.; Mihaljevic, A.L.; Büchler, M.W.; Diener, M.K. Optimal literature search for systematic reviews in surgery. Langenbeck’s Arch. Surg. 2018, 403, 119–129.(in Russ).
Murphy, M.M.; Witkowski, E.R.; Ng, S.C.; McDade, T.P.; Hill, J.S.; Larkin, A.C.; Whalen, G.F.; Litwin, D.E.; Tseng, J.F. Trends in adrenalectomy: A recent national review. Surg. Endosc. 2010, 24, 2518–2526.(in Russ).
Ross, E.J.; Prichard, B.N.; Kaufman, F.; Robertson, A.I.; Harries, B.J. Papers and Originals Preoperative and Operative Management of Patients with Phaeochromocytoma. BMJ 1967, 1, 191–198.(in Russ).
Riddell, D.H.; Schull, L.G.; Frist, T.F.; Baker, T.D. Experience with pheochromocytoma in 21 patients: Use of dichloroisoproterenol hydrochloride for cardiac arrhythmia. Ann. Surg. 1963, 157, 980–988.(in Russ).
Assalia, A.; Gagner, M. Laparoscopic adrenalectomy. J. Br. Surg. 2004, 91, 1259–1274.
Janetschek, G.; Finkenstedt, G.; Gasser, R.; Waibel, U.G.; Peschel, R.; Bartsch, G. Laparoscopic surgery for pheochromocytoma: Adrenalectomy, partial resection, excision of paragangliomas. J. Urol. 1998, 160, 330–334.(in Russ).
Terachi, T.; Matsuda, T.; Terai, A.; Ogawa, O.; Kakehi, Y.; Wakita, M.K. Transperitoneal Laparoscopic Adrenalectomy: Experience in 100 Patients. J. Endourol. 1997, 11, 361–365.(in Russ).
Lenders, J.W.M.; Duh, Q.Y.; Eisenhofer, G.; Gimenez-Roqueplo, A.P.; Grebe, S.K.G.; Murad, M.H. Pheochromocytoma and paraganglioma: An endocrine society clinical practice guideline. J. Clin. Endocrinol. Metab. 2014, 99, 1915–1942.(in Russ).
Vargas, H.I.; Kavoussi, L.R.; Bartlett, D.L.; Wagner, J.R.; Venzon, D.J.; Fraker, D.L. Laparoscopic adrenalectomy; a new standard of care. Urology 1997, 49, 673–678.(in Russ).
Schell, S.R.; Talamini, M.A.; Udelsman, R. Laparoscopic adrenalectomy for nonmalignant disease: Improved safety, morbidity, and cost-effectiveness. Surg. Endosc. 1999, 13, 30–34.(in Russ).
Wang, W.; Li, P.; Wang, Y.; Wang, Y.; Ma, Z.; Wang, G. Effectiveness and safety of laparoscopic adrenalectomy of large pheochromocytoma: A prospective, nonrandomized, controlled study. Am. J. Surg. 2015, 210, 230–235.(in Russ).
Li, J.; Wang, Y.; Chang, X.; Han, Z. Laparoscopic adrenalectomy (LA) vs open adrenalectomy (OA) for pheochromocytoma (PHEO): A systematic review and meta-analysis. Eur. J. Surg. Oncol. 2020, 46, 991–998.(in Russ).
Tanaka, M.; Tokuda, N.; Koga, H.; Kimoto, Y.; Naito, S. Laparoscopic Adrenalectomy for Pheochromocytoma: Comparison with Open Adrenalectomy and Comparison of Laparoscopic Surgery for Pheochromocytoma versus Other Adrenal Tumors Conclusions: Laparoscopic adrenalectomy does not increase the specific risks associated with surgery for pheochromocytoma. It is a minimally invasive alternative to conventional open adrenalectomy. J. Endourol. 2000, 14, 427–431.(in Russ).
Toniato, A.; Boschin, I.M.; Opocher, G.; Guolo, A.; Pelizzo, M.; Mantero, F. Is the laparoscopic adrenalectomy for pheochromocytoma the best treatment? Surgery 2007, 141, 723–727.(in Russ).
Bai, S.; Yao, Z.; Zhu, X.; Li, Z.; Jiang, Y.; Wang, R.; Wu, B. Comparison of transperitoneal laparoscopic versus open adrenalectomy for large pheochromocytoma: A retrospective propensity score-matched cohort study. Int. J. Surg. 2019, 61, 26–32.(in Russ).
Tiberio, G.A.M.; Baiocchi, G.L.; Arru, L.; Rosei, C.A.; De Ponti, S.; Matheis, A.; Rizzoni, D.; Giulini, S.M. Prospective randomized comparison of laparoscopic versus open adrenalectomy for sporadic pheochromocytoma. Surg. Endosc. 2008, 22, 1435–1439.(in Russ).
Inabnet, W.B.; Pitre, J.; Bernard, D.; Chapuis, Y. Comparison of the hemodynamic parameters of open and laparoscopic adrenalectomy for pheochromocytoma. World J. Surg. 2000, 24, 574–578.(in Russ).
Möbius, E.; Nies, C.; Rothmund, M. Surgical treatment of pheochromocytomas Laparoscopic or conventional ? Surg. Endosc. 1999, 13, 35–39.(in Russ).
Kasahara, T.; Nishiyama, T.; Takahashi, K. Laparoscopic adrenalectomy for pheochromocytoma: Evaluation of experience and strategy at a single institute. BJU Int. 2009, 103, 218–222.(in Russ).
Kazaryan, A.M.; Kuznetsov, N.S.; Shulutko, A.M.; Beltsevich, D.G.; Edwin, B. Evaluation of endoscopic and traditional open approaches to pheochromocytoma. Surg. Endosc 2004, 18, 937–941.(in Russ).
Agarwal, G.; Sadacharan, D.; Aggarwal, V.; Chand, G.; Mishra, A.; Agarwal, A. Surgical management of organ-contained unilateral pheochromocytoma: Comparative outcomes of laparoscopic and conventional open surgical procedures in a large single-institution series. Langenbeck′s Arch. Surg. 2012, 397, 1109–1116.(in Russ).
Sprung, J.; O’hara, J.F.; Gill, I.S.; Abdelmalak, B.; Sarnaik, A.; Bravo, E.L. Anesthetic aspects of laparoscopic and open adrenalectomy for pheochromocytoma. Urology 2000, 55, 339–343.(in Russ).
Ichikawa, T.; Mikami, K.; Suzuki, H.; Imamoto, T.; Yamazaki, T.; Naya, Y. Adrenal: Laparoscopic adrenalectomy for pheochromocytoma. Biomed. Pharmacother. 2002, 56 (Suppl. S1), 149–153.(in Russ).
Fang, F.; Ding, L.; He, Q.; Liu, M. Preoperative Management of Pheochromocytoma and Paraganglioma. Front. Endocrinol. 2020, 11, 586795.(in Russ).
Kim, H.H.; Han Kim, G.; Tak Sung, G. Laparoscopic Adrenalectomy for Pheochromocytoma: Comparison with Conventional Open Adrenalectomy. J. Endourol. 2004, 18, 251–255.(in Russ).
Brunaud, L.; Nguyen-Thi, P.L.; Mirallie, E.; Raffaelli, M.; Vriens, M.; Theveniaud, P.E. Predictive factors for postoperative morbidity after laparoscopic adrenalectomy for pheochromocytoma: A multicenter retrospective analysis in 225 patients. Surg. Endosc. 2016, 30, 1051–1059.(in Russ).
Groeben, H.; Walz, M.K.; Nottebaum, B.J.; Alesina, P.F.; Greenwald, A.; Schumann, R. International multicentre review of perioperative management and outcome for catecholamine-producing tumours. Br. J. Surg. 2020, 107, e170–e178.(in Russ).
Buitenwerf, E.; Osinga, T.E.; Timmers, H.J.; Lenders, J.W.; Feelders, R.A.; Eekhoff, E.M. Efficacy of α-blockers on hemodynamic control during pheochromocytoma resection-a randomized controlled trial. J. Clin. Endocrinol. Metab. 2020, 105, 2381–2391.(in Russ).
Goldstein, R.E.; O’neill, J.A.; Holcomb Iii, G.W.; Iii, W.M.M.; Neblett Iii, W.W.; Oates, J.A. Clinical Experience Over 48 Years With Pheochromocytoma. Ann. Surg. 1999, 229, 755–764.(in Russ).
Roizen, M.F.; Hunt, T.K.; Beaupre, P.N.; Kremer, P.; Firmin, R.; Chang, C.N.; Alpert, R.A.; Thomas, C.J.; Tyrrell, J.B.; Cahalan, B.J. The effect of alpha-adrenergic blockade on cardiac performance and tissue oxygen delivery during excision of pheochromocytoma. Surgery 1983, 94, 941–945.(in Russ).
Bruynzeel, H.; Feelders, R.A.; Groenland, T.H.N.; van den Meiracker, A.H.; van Eijck, C.H.J.; Lange, J.F. Risk factors for hemodynamic instability during surgery for pheochromocytoma. J. Clin. Endocrinol. Metab. 2010, 95, 678–685.(in Russ).
Brunaud, L.; Boutami, M.; Nguyen-Thi, P.L.; Finnerty, B.; Germain, A.; Weryha, G. Both preoperative alpha and calcium channel blockade impact intraoperative hemodynamic stability similarly in the management of pheochromocytoma. Surgery 2014, 156, 1410–1418. .(in Russ).
Jaiswal, S.K.; Memon, S.S.; Lila, A.; Sarathi, V.; Goroshi, M.; Garg, R.; Barnabas, R.; Hemantkumar, I.; Patel, R.D.; Oak, S.; et al. Preoperative Amlodipine Is Efficacious in Preventing Intraoperative HDI in Pheochromocytoma: Pilot RCT. J. Clin. Endocrinol. Metab. 2021, 106, e2907–e2918.(in Russ).
Dubé, L.; Granry, J.C. The therapeutic use of magnesium in anesthesiology, intensive care and emergency medicine: A review. Can. J. Anaesth. 2003, 50, 732–746. [Google Scholar]
Urabe, F.; Kimura, S.; Iwatani, K.; Takahashi, K.; Ito, K.; Tashiro, K. Risk factors for perioperative hemodynamic instability in pheochromocytoma: A systematic review and meta-analysis. J. Clin. Med. 2021, 10, 4531.(in Russ).
Lentschener, C.; Gaujoux, S.; Tesniere, A.; Dousset, B. Point of controversy: Perioperative care of patients undergoing pheochromocytoma removal-time for a reappraisal? Eur. J. Endocrinol. 2011, 165, 365–373.(in Russ).
Namekawa, T.; Utsumi, T.; Kawamura, K.; Kamiya, N.; Imamoto, T.; Takiguchi, T. Clinical predictors of prolonged postresection hypotension after laparoscopic adrenalectomy for pheochromocytoma. Surgery 2016, 159, 763–770.(in Russ).
Kiernan, C.M.; Du, L.; Chen, X.; Broome, J.T.; Shi, C.; Peters, M.F. Predictors of Hemodynamic Instability During Surgery for Pheochromocytoma. Ann. Surg. Oncol. 2014, 21, 3865–3871.(in Russ).
Zawadzka, K.; Więckowski, K.; Małczak, P.; Wysocki, M.; Major, P.; Pędziwiatr, M. Selective vs non-selective alpha-blockade prior to adrenalectomy for pheochromocytoma: Systematic review and meta-analysis. Eur. J. Endocrinol. 2021, 184, 751–760.(in Russ).
Schimmack, S.; Kaiser, J.; Probst, P.; Kalkum, E.; Diener, M.K.; Strobel, O. Meta-analysis of α-blockade versus no blockade before adrenalectomy for phaeochromocytoma. Br. J. Surg. 2020, 107, e102–e108.(in Russ).
Groeben, H.; Nottebaum, B.J.; Alesina, P.F.; Traut, A.; Neumann, H.P.; Walz, M.K. Perioperative α-receptor blockade in phaeochromocytoma surgery: An observational case series. Br. J. Anaesth. 2017, 118, 182–189.(in Russ).
Araujo-Castro, M.; Pascual-Corrales, E.; Nattero Chavez, L.; Martínez Lorca, A.; Alonso-Gordoa, T.; Molina-Cerrillo, J. Protocol for presurgical and anesthetic management of pheochromocytomas and sympathetic paragangliomas: A multidisciplinary approach. J. Endocrinol. Investig 2021, 44, 2545–2555.(in Russ).
Tan, S.G.; Koay, C.K.; Chan, S.T. The Use of Vasopressin to Treat Catecholamine-resistant Hypotension After Phaeochromocytoma Removal. Anaesth. Intensive Care 2002, 30, 477–480.(in Russ).
Boutros, A.R.; Bravo, E.L.; Zanettin, G.; Straffon, R.A. Perioperative management of 63 patients with pheochromocytoma. Clevel. Clin. J. Med. 1990, 57, 613–617.(in Russ).
