Background
Evidence on follow-up duration for patients with sporadic pheochromocytomas is absent and current guidelines of the European Society of Endocrinology (ESE) and American Association of Clinical Endocrinologists and Endocrine Surgeons (AACE/AAES) suggest no definite duration. The aim of this systematic review and meta-analysis is to evaluate the recurrence rate and time to recurrence of sporadic pheochromocytomas after curative adrenalectomy. 

Methods

A literature search in PubMed, Embase and the Cochrane Library was performed. A study was found to be eligible when it contained a clear report on the number of sporadic patients, recurrence rate and follow-up duration. Studies with an inclusion period before 1990, <2 years of follow-up, <10 patients and unclear data on sporadic nature of pheochromocytomas were excluded. A meta-analysis on recurrence was performed provided that the heterogeneity was low (I² < 25%) or intermediate (I² 26-75%). Hozo’s method was used to calculate weighted mean follow-up duration and weighted time to recurrence with combined standard deviations.

Results

A total of 13 studies, including 430 patients, were included in the synthesis. The meta-analysis results describe a pooled recurrence rate after curative surgery of 3% (95%CI 2-6%, I² = 0%) with a weighted mean time to recurrence of 49.4 months (SD = 30.7) and a weighted mean follow-up period of 77.3 months (SD = 32.2).

Conclusions

This meta-analysis shows a very low recurrence rate of 3%, indicating that the discussion on health care outcomes should be reopened. Even more so since the false positive rates of screening for a recurrent pheochromocytoma are not low.