Predictors of postoperative recurrence of pheochromocytoma: a monocentric study

Objective: To discuss the risk factors affecting the recurrence of pheochromocytoma (PCC) following surgery. Methods: We retrospectively reviewed patients who were hospitalized and underwent surgery for PCC between January 2012 and December 2020 at Chinese People’s Liberation Army (PLA) General Hospital. Inclusion criteria were pathological diagnosis of PCC and availability of follow up. Results: In total, 451 patients met the inclusion criteria. The average age was 45.89 years, and the median tumor diameter was 5.75 cm. The mean recurrence time was 34.24 months. Of the 451 patients receiving surgery, there were 35 recurrent cases (7.85%). The univariate test showed that age, hypertension, history of PCC recurrence, Ki-67 index ≥ 5, bilateral tumor, duration of phenazopyridine administration, DBP at admission, open operation, intraoperative HR minimum, the number of episodes of intraoperative HR over 120 bpm, the number of episodes of intraoperative hemodynamic instability, and intraoperative bleeding were associated with recurrence after surgery. Multivariate COX regression analysis of age (hazard ratio 0.95), hypertension (hazard ratio 7.14), history of PCC recurrence (hazard ratio 69.35), family history of hypertension (hazard ratio 16.30), bilateral tumor (hazard ratio 7.38), tumor size (hazard ratio 1.05), the number of episodes of hemodynamic instability (hazard ratio 114.91) and duration of intraoperative instability (hazard ratio 1.12) were the independent risk factors on recurrence following surgery. Conclusions: Age, hypertension, history of PCC recurrence, family history of hypertension, bilateral tumor, tumor size, the number of episodes and the duration of intraoperative hemodynamic instability were independent risk factors on recurrence following surgery. Clinical trial number: Not applicable. © The Author(s) 2025.