{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T01:01:09Z","timestamp":1769043669328,"version":"3.49.0"},"reference-count":19,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2014,1,6]],"date-time":"2014-01-06T00:00:00Z","timestamp":1388966400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2014,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Subdiaphragmatic paraganglioma is a rare neuroendocrine tumor for which scarce data exist regarding long\u2010term patient outcome following resection. The aim of this study was to determine the association of surgical resection with survival.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective study at a tertiary care center was performed. Demographics, genetics, histology, and operative details were reviewed. Patients were grouped according to margin status (R0, R1, or R2) and survival calculated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 50 patients with subdiaphragmatic paragangliomas underwent primary resection from 1999 to 2012. Median age at operation was 46 years, with a median tumor size of 6.0\u00a0cm. Of these patients, 30 (60 %) had a R0 resection, 11 (22 %) had a R1 resection, and 9 (18 %) had a R2 resection. There was no operative mortality, and 17 (34 %) patients had metastatic disease. Six (12 %) patients died, four (8 %) of whom had metastatic disease. Univariate analysis identified that age &gt;50 years (<jats:italic>p<\/jats:italic> = 0.02) and undergoing a R2 resection (<jats:italic>p<\/jats:italic> = 0.03) were associated with a shorter overall survival (OS). Those with metastases at some point after their initial diagnosis had a shorter disease\u2010free survival (DFS) than those without metastases (<jats:italic>p<\/jats:italic> = 0.04). Of 27 patients tested, 12 (44 %) had a germline succinyl dehydrogenase B (SDHB) mutation. SDHB immunohistochemistry identified 18 patients (of 27 who underwent staining) who had loss of SDHB expression in which 7 of 11 patients (63 %) who underwent genetic testing had a genetic mutation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Surgical resection of subdiaphragmatic paraganglioma is safe. Survival was longest in patients who were younger, with no metastases, or had a R0 or R1 resection. Patients who test negative for a germline mutation should undergo SDHB immunostaining to identify potential hereditary carriers missed by current genetic testing.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-013-2443-5","type":"journal-article","created":{"date-parts":[[2014,1,5]],"date-time":"2014-01-05T21:26:27Z","timestamp":1388957187000},"page":"733-741","source":"Crossref","is-referenced-by-count":7,"title":["Impact of Surgical Resection for Subdiaphragmatic Paragangliomas"],"prefix":"10.1002","volume":"38","author":[{"given":"Shabirhusain S.","family":"Abadin","sequence":"first","affiliation":[{"name":"Department of Surgical Oncology, Unit 1484 The University of Texas MD Anderson Cancer Center P.O. Box 301402 77230\u20101402 Houston TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Montserrat","family":"Ayala\u2010Ramirez","sequence":"additional","affiliation":[{"name":"Department of Endocrine Neoplasia and Hormonal Disorders The University of Texas MD Anderson Cancer Center Houston TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Camilo","family":"Jimenez","sequence":"additional","affiliation":[{"name":"Department of Endocrine Neoplasia and Hormonal Disorders The University of Texas MD Anderson Cancer Center Houston TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paxton V.","family":"Dickson","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, Unit 1484 The University of Texas MD Anderson Cancer Center P.O. Box 301402 77230\u20101402 Houston TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu","family":"Liang","sequence":"additional","affiliation":[{"name":"Department of Pathology The University of Texas MD Anderson Cancer Center Houston TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander J.","family":"Lazar","sequence":"additional","affiliation":[{"name":"Department of Pathology The University of Texas MD Anderson Cancer Center Houston TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason L.","family":"Hornick","sequence":"additional","affiliation":[{"name":"Department of Pathology Brigham and Women\u2019s Hospital Boston MA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Cotton","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, Unit 1484 The University of Texas MD Anderson Cancer Center P.O. Box 301402 77230\u20101402 Houston TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dawen","family":"Sui","sequence":"additional","affiliation":[{"name":"Department of Biostatistics The University of Texas MD Anderson Cancer Center Houston TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thereasa","family":"Rich","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, Unit 1484 The University of Texas MD Anderson Cancer Center P.O. Box 301402 77230\u20101402 Houston TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey E.","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, Unit 1484 The University of Texas MD Anderson Cancer Center P.O. Box 301402 77230\u20101402 Houston TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth","family":"Grubbs","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, Unit 1484 The University of Texas MD Anderson Cancer Center P.O. Box 301402 77230\u20101402 Houston TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nancy D.","family":"Perrier","sequence":"additional","affiliation":[{"name":"Department of Surgical Oncology, Unit 1484 The University of Texas MD Anderson Cancer Center P.O. 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