{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T11:40:39Z","timestamp":1777894839695,"version":"3.51.4"},"reference-count":29,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2015,10,14]],"date-time":"2015-10-14T00:00:00Z","timestamp":1444780800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100005006","name":"Asan Institute for Life Sciences, Asan Medical Center","doi-asserted-by":"publisher","award":["2015\u2010095"],"award-info":[{"award-number":["2015\u2010095"]}],"id":[{"id":"10.13039\/501100005006","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Surgical Oncology"],"published-print":{"date-parts":[[2015,12]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Malignant pheochromocytoma (PCC)\/paraganglioma (PG) are rare neuroendocrine malignancies, and their clinical courses and prognoses are not well understood. This study aimed to evaluate prognostic factors associated with the survival of malignant PCC\/PG.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective study reviewed 299 patients with PCC and 46 with PG treated between 1997 and 2013 at our single tertiary hospital. Malignant PCC\/PG was defined as the presence of distant metastasis or recurrence at sites where neuroendocrine tissue is normally not present.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty\u2010seven patients (9%) were confirmed with malignant PCC and six patients (13%) with malignant PG. Twenty\u2010seven patients (82%) had distant metastases, nine patients (27%) presented with a metastasis at the initial diagnosis, whilst 24 patients (73%) were diagnosed with malignant PCC\/PG during follow\u2010up (median, 4.3 year). The median survival was 7.2 years, and the 5 year survival rate was 75.4%. Older age (&gt;45 years), larger tumor size (&gt;6\u2009cm), synchronous metastasis, and absence of surgical excision were associated with poor survival by univariate analysis. By multivariate analysis, older age (HR\u2009=\u20094.3, <jats:italic>P<\/jats:italic>\u2009=\u20090.02) and synchronous metastasis (HR\u2009=\u20094.3, <jats:italic>P<\/jats:italic>\u2009=\u20090.01) were significantly associated with a poor prognosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Patients with malignant PCC\/PG have diverse clinical courses. Poor survival was independently associated with older age and synchronous metastasis. <jats:italic>J. Surg. Oncol. 2015;112:815\u2013821<\/jats:italic>. \u00a9 2015 Wiley Periodicals, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jso.24063","type":"journal-article","created":{"date-parts":[[2015,10,14]],"date-time":"2015-10-14T07:15:01Z","timestamp":1444806901000},"page":"815-821","source":"Crossref","is-referenced-by-count":35,"title":["Clinical course and prognostic factors in patients with malignant pheochromocytoma and paraganglioma: A single institution experience"],"prefix":"10.1002","volume":"112","author":[{"given":"Yun Mi","family":"Choi","sequence":"first","affiliation":[{"name":"Department of Internal Medicine Asan Medical Center University of Ulsan College of Medicine Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tae\u2010Yon","family":"Sung","sequence":"additional","affiliation":[{"name":"Department of Surgery Asan Medical Center University of Ulsan College of Medicine Seoul Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Won 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