Evidence map›Paper›PMID 41533247›Full record

ArticleJournal of neuro-oncology2026

Surgical resection versus stereotactic radiosurgery for succinate dehydrogenase-related hereditary head and neck paragangliomas.

Paul M Harary, Yusuke S Hori, Fred C Lam, Deya Abu-Reesh, Sara C Emrich, Armine Tayag, Louisa Ustrzynski, Jennifer Alyono, F Christopher Holsinger, Robert L Dodd and 4 more

Abstract readComparative Study
PubMed Publisher
In one paragraph

Article in Journal of neuro-oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

14 authors.

Paul M HararyDepartment of Neurosurgery, Stanford University School of Medicine, 453 Quarry Rd, Stanford, CA, 94304, USA.ORCID http://orcid.org/0000-0002-4683-2115
Yusuke S HoriDepartment of Neurosurgery, Stanford University School of Medicine, 453 Quarry Rd, Stanford, CA, 94304, USA. yshori@stanford.edu.ORCID http://orcid.org/0000-0001-9921-6810
Fred C LamDepartment of Neurosurgery, Stanford University School of Medicine, 453 Quarry Rd, Stanford, CA, 94304, USA.
Deya Abu-ReeshDepartment of Neurosurgery, Stanford University School of Medicine, 453 Quarry Rd, Stanford, CA, 94304, USA.
Sara C EmrichDepartment of Neurosurgery, Stanford University School of Medicine, 453 Quarry Rd, Stanford, CA, 94304, USA.
Armine TayagDepartment of Neurosurgery, Stanford University School of Medicine, 453 Quarry Rd, Stanford, CA, 94304, USA.
Louisa UstrzynskiDepartment of Neurosurgery, Stanford University School of Medicine, 453 Quarry Rd, Stanford, CA, 94304, USA.
Jennifer AlyonoDepartment of Otolaryngology, Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA, USA.ORCID http://orcid.org/0000-0002-3877-2159
F Christopher HolsingerDepartment of Otolaryngology, Head and Neck Surgery, Stanford University School of Medicine, Stanford, CA, USA.ORCID http://orcid.org/0000-0002-9594-1414
Robert L DoddDepartment of Neurosurgery, Stanford University School of Medicine, 453 Quarry Rd, Stanford, CA, 94304, USA.ORCID http://orcid.org/0000-0001-5609-9474
Iris C GibbsDepartment of Radiation Oncology, Stanford University School of Medicine, Stanford, CA, USA.ORCID http://orcid.org/0000-0002-2693-7980
Gordon LiDepartment of Neurosurgery, Stanford University School of Medicine, 453 Quarry Rd, Stanford, CA, 94304, USA.ORCID http://orcid.org/0000-0001-8372-0676
David J ParkDepartment of Neurosurgery, Stanford University School of Medicine, 453 Quarry Rd, Stanford, CA, 94304, USA.ORCID http://orcid.org/0000-0002-9858-2592
Steven D ChangDepartment of Neurosurgery, Stanford University School of Medicine, 453 Quarry Rd, Stanford, CA, 94304, USA. sdchang@stanford.edu.ORCID http://orcid.org/0000-0002-4315-681X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeSuccinate dehydrogenase (SDH) mutations are strongly associated with head and neck paraganglioma (HN-PGL), with recent evidence suggesting differences in tumor behavior relative to sporadic lesions. However, the optimal treatment strategy for this population remains unclear. We therefore compared the efficacy of surgical resection versus stereotactic radiosurgery (SRS) in patients with SDH-mutant HN-PGL.

methodsWe retrospectively analyzed patients diagnosed with SDH-related HN-PGL who received treatment at our institution between September 1994 and September 2024. We reviewed clinical histories, genetic results, treatment parameters, and outcomes. Follow-up included clinical evaluations and radiological assessment. The primary outcome was local control, while the secondary outcome was treatment-related adverse events. A P-value of < 0.05 was considered statistically significant.

resultsThe study included a total of 29 patients with SDH-related HN-PGL, encompassing 40 lesions treated with either SRS (n = 16) or surgical resection (n = 24). Mean age at diagnosis was similar between groups (35.6 vs. 33.6 years). The majority of patients had SDHD mutations (75.8%), and 34.5% were symptomatic before treatment, with pulsatile tinnitus (24.1%), hearing loss (13.8%), and dysphagia (13.8%) being the most common symptoms. The median prescribed dose for SRS was 20.5 Gy, with a median biologically effective dose of 132 Gy2. Median follow-up duration was 37.4 months and 111.0 months for SRS and resection, respectively (P = 0.066). SRS had significantly fewer post-treatment complications (10% vs. 47.4%, P = 0.046). Specifically, new or worsened hoarseness, dysphagia, and hearing loss were more prevalent in the resection group. At last follow-up, the local control rate was more favorable in the SRS versus the resection arm, although this did not rise to statistical significance in time-to-event analysis (P = 0.12, log-rank test). Five patients who underwent resection required reoperation.

conclusionSRS was associated with significantly fewer complications and a trend toward higher local control compared to surgical resection for SDH-related HN-PGL. Given the slow growth and frequent multifocality of hereditary HN-PGLs, a less aggressive treatment approach may reduce the need for surgery and its complications. However, further investigation with long-term follow-up is warranted to fully assess durability of disease control.

Indexed as

Head and Neck NeoplasmsParagangliomaRadiosurgerySuccinate DehydrogenaseAdolescentAdultFemaleFollow-Up StudiesHumansMaleMiddle AgedMutationRetrospective StudiesYoung AdultSuccinate DehydrogenaseCancer predispositionGeneticsHereditary paragangliomaStereotactic radiosurgerySuccinate dehydrogenaseSurgery

Identifiers

PMID41533247

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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.