Evidence map›Paper›PMID 37945270›Full record

SynthesisBJS open2023

Total adrenalectomy versus subtotal adrenalectomy for bilateral pheochromocytoma: meta-analysis.

Donatella Schiavone, Mattia Ballo, Marco Filardo, Silvia Dughiero, Francesca Torresan, Gian Paolo Rossi, Maurizio Iacobone

Open access · goldAbstract readMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BJS open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
1.6field-weighted citation impact, top 16% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 5 citations in OpenAlex.

  1. Review
  2. Article
  3. Article
  4. Review
  5. Progress in surgical approaches and outcomes of patients with pheochromocytoma and paraganglioma.Best practice & research. Clinical endocrinology & metabolism · 2025
    Review
  6. Article
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 1 institution in 1 country.

Donatella SchiavoneDepartment of Medicine-DIMED, University of Padua, Padua, Italy.
Mattia BalloEndocrine Surgery Unit, Department of Surgery, Oncology, and Gastroenterology, University of Padua, Padua, Italy.
Marco FilardoEndocrine Surgery Unit, Department of Surgery, Oncology, and Gastroenterology, University of Padua, Padua, Italy.
Silvia DughieroEndocrine Surgery Unit, Department of Surgery, Oncology, and Gastroenterology, University of Padua, Padua, Italy.
Francesca TorresanEndocrine Surgery Unit, Department of Surgery, Oncology, and Gastroenterology, University of Padua, Padua, Italy.
Gian Paolo RossiInternal and Emergency Unit and Specialized Hypertension Centre, Department of Medicine-DIMED, University of Padua, Padua, Italy.ORCID 0000-0002-7963-0931
Maurizio IacoboneEndocrine Surgery Unit, Department of Surgery, Oncology, and Gastroenterology, University of Padua, Padua, Italy.ORCID 0000-0002-6057-4642
University of Padua · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundBilateral pheochromocytomas are rare and often heritable. Total adrenalectomy leads to a definitive oncological cure, with subsequent definitive hypocortisolism. Subtotal adrenalectomy is a possible alternative. The aim of this study was to assess the effects of total adrenalectomy and subtotal adrenalectomy on bilateral pheochromocytoma in terms of post-surgical rate of recurrence, metastatic disease, and steroid dependence.

methodsSystematic searches in the bibliographic databases PubMed, Embase, and Europe PMC were performed for 1945 to 1 June 2023. PRISMA guidelines were followed and the PICO strategy was applied to English-language studies comparing subtotal adrenalectomy with total adrenalectomy. A random-effects model was used to assess the different outcomes for studies with high heterogeneity. The Newcastle-Ottawa scale and the Risk Of Bias In Non-randomized Studies of Interventions ('ROBINS-I') tool were used to assess quality and risk of bias.

resultsFrom a total of 12 909 studies, 1202 patients (from 10 retrospective studies) were eligible for the meta-analysis. In six studies, including 1176 patients, the recurrence rate after subtotal adrenalectomy and total adrenalectomy was 14.1 versus 2.6 per cent respectively (OR 4.91, 95 per cent c.i. 1.30 to 18.54; P = 0.020; I2 72 per cent). In nine studies, including 1124 patients, the rate of post-surgical steroid dependence was 93.3 versus 11.6 per cent after total adrenalectomy and subtotal adrenalectomy respectively (OR 0.003, 95 per cent c.i. 0.0003 to 0.03; P < 0.00001; I2 66 per cent). Based on two studies, including 719 patients, no differences were evident regarding the occurrence of post-surgery metastatic disease.

conclusionSubtotal adrenalectomy leads to less post-surgical primary adrenal insufficiency, but leads to a higher postoperative recurrence rate. Future prospective randomized studies, with clear eligibility criteria, are needed to confirm these results.

Indexed as

Adrenal Gland NeoplasmsPheochromocytomaAdrenalectomyHumansRetrospective StudiesSteroidsSteroids

Identifiers

PMID37945270
PMCPMC10635800
OpenAlexW4388551030

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.