Clinical Characteristics and Surgical Outcomes of Bladder Paraganglioma: A 20-Year Nationwide Center Experience

IF 2.7 3区医学 Q3 ONCOLOGY

Clinical genitourinary cancer Pub Date : 2025-07-10 DOI:10.1016/j.clgc.2025.102397

Wencong Han , Xiaoteng Yu , Shiwei Chen , Zejin Ou , Tai Kang , Zheng Zhang

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引用次数: 0

Abstract

Objective

: Bladder paraganglioma (BPGL) is a rare neuroendocrine tumor. This study evaluates the clinical characteristics, perioperative course, and long-term outcomes of BPGL treated at a nationwide center over the past 2 decades.

Methods

A retrospective review was conducted on 45 patients who underwent surgery for BPGL between January 2004 and September 2024. Demographic data, clinical features, tumor characteristics, surgical approach, intraoperative hemodynamic instability (HDI), and follow-up outcomes were assessed.

Results

The median age of patients was 54.0 years (IQR, 36.5, 65.0), with 66.4% being female. A preoperative diagnosis was made in 53.3% of cases. Younger patients (age ≤40 years) exhibited more catecholamine-related symptoms (75.0% vs. 24.2%, P = .006), larger tumor sizes (4.3 cm vs. 1.8 cm, P = .010), higher plasma normetanephrine levels (14.0 nmol/L vs. 1.9 nmol/L, P = .014), were more likely to be diagnosed preoperatively (83.3% vs. 42.4%, P = .015), and had a higher rate of metastasis (41.7% vs. 3.0%, P = .004) compared to older patients. Intraoperative HDI occurred in 51.1% of patients. Prolonged anesthesia (189.0 min vs. 97.5 min, P = .013) and surgery time (134.0 min vs. 25.5 min, P = .005) were significantly associated with HDI. The median follow-up time was 5.1 years (IQR, 1.4-8.3 years), during which 1 patient (2.4%) experienced recurrence, and 1 patient (2.4%) died from the disease. No other patients experienced recurrence or metastasis.

Conclusion

Younger age predicts more aggressive BPGL behavior. Transurethral resection (TUR) is a safe and effective option for tumors ≤3 cm. Early recognition, meticulous perioperative management and lifelong surveillance are essential to optimize outcomes.

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膀胱副神经节瘤的临床特征和手术结果：一个20年的全国中心经验

目的：膀胱副神经节瘤（BPGL）是一种罕见的神经内分泌肿瘤。本研究评估了过去20年来在一个全国性中心治疗的BPGL的临床特征、围手术期过程和长期结果。方法回顾性分析2004年1月至2024年9月间行BPGL手术治疗的45例患者。评估人口统计学资料、临床特征、肿瘤特征、手术入路、术中血流动力学不稳定性（HDI）和随访结果。结果患者中位年龄为54.0岁（IQR分别为36.5、65.0），女性占66.4%。术前诊断率为53.3%。年轻患者（年龄≤40岁）表现出更多的儿茶酚胺相关症状（75.0%比24.2%,P = 0.006），肿瘤体积较大（4.3 cm比1.8 cm, P = 0.010），血浆去甲肾上腺素水平较高（14.0 nmol/L比1.9 nmol/L, P = 0.014），术前确诊率较高（83.3%比42.4%,P = 0.015），转移率较高（41.7%比3.0%,P = 0.004）。术中HDI发生率为51.1%。麻醉时间延长（189.0 min vs. 97.5 min, P = 0.013）和手术时间延长（134.0 min vs. 25.5 min, P = 0.005）与HDI显著相关。中位随访时间为5.1年（IQR, 1.4-8.3年），其中1例（2.4%）复发，1例（2.4%）死亡。其他患者无复发或转移。结论年龄越小，BPGL行为越具有攻击性。对于≤3cm的肿瘤，经尿道切除术（TUR）是一种安全有效的选择。早期识别，细致的围手术期管理和终身监测是优化预后的必要条件。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical genitourinary cancer 医学-泌尿学与肾脏学

CiteScore

5.20

自引率

6.20%

发文量

201

审稿时长

54 days

期刊介绍： Clinical Genitourinary Cancer is a peer-reviewed journal that publishes original articles describing various aspects of clinical and translational research in genitourinary cancers. Clinical Genitourinary Cancer is devoted to articles on detection, diagnosis, prevention, and treatment of genitourinary cancers. The main emphasis is on recent scientific developments in all areas related to genitourinary malignancies. Specific areas of interest include clinical research and mechanistic approaches; drug sensitivity and resistance; gene and antisense therapy; pathology, markers, and prognostic indicators; chemoprevention strategies; multimodality therapy; and integration of various approaches.