{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T01:52:01Z","timestamp":1792547521423,"version":"4.5.0"},"reference-count":40,"publisher":"The Endocrine Society","issue":"9","license":[{"start":{"date-parts":[[2021,3,29]],"date-time":"2021-03-29T00:00:00Z","timestamp":1616976000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,8,18]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Context<\/jats:title>\n                  <jats:p>The behavior of locally advanced pheochromocytoma (LAP) remains unknown.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>We characterized the population with LAP and recurrence-free survival (RFS).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This retrospective multicentric study was run within the ENDOCAN-COMETE network and French Group of Endocrine Tumors (GTE) from 2003 to 2018, including patients from 11 French referral centers with LAP as defined by capsular invasion, vascular invasion, adipose tissue invasion, and\/or positive locoregional lymph nodes at diagnosis without evidence of distant metastasis. The main outcome measure was recurrence, defined as tumor reappearance, including local site and\/or distant metastasis. The primary endpoint was RFS analysis; secondary endpoints were characterization, overall survival (OS), and prognostic factors of recurrence.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Among 950 patients, 90 (9%) exhibited LAP criteria and 55 met inclusion criteria (median age, 53 years; 61% males; 14% with germline mutation; 84% with catecholamine excess). LAP was defined by 31 (56%) capsular invasions, 27 (49%) fat invasions, 6 (11%) positive lymph nodes, and 22 (40%) vascular invasions. After median follow-up of 54 months (range, 6-180), 12 patients (22%) had recurrences and 3 (5%) died of metastatic disease. Median RFS was 115 months (range, 6-168). Recurrences were local in 2 patients, distant in 2, and both local and distant in 8 patients. Median OS of patients was not reached. Size above 6.5 cm (P = 0.019) and Ki-67 &amp;gt; 2% (P = 0.028) were identified as independent significant prognostic factors in multivariate analysis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>LAP represents 9% of pheochromocytoma\u2019s population and has a metastatic behavior. This study paves the way for future pathological TNM classification.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1210\/clinem\/dgab202","type":"journal-article","created":{"date-parts":[[2021,3,30]],"date-time":"2021-03-30T05:47:05Z","timestamp":1617083225000},"page":"2726-2737","source":"Crossref","is-referenced-by-count":18,"title":["Recurrence-Free Survival Analysis in Locally Advanced Pheochromocytoma: First Appraisal"],"prefix":"10.1210","volume":"106","author":[{"given":"Sophie","family":"Moog","sequence":"first","affiliation":[{"name":"Endocrine Oncology Unit, Gustave Roussy, F-94805, Villejuif, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1808-8800","authenticated-orcid":false,"given":"Fr\u00e9d\u00e9ric","family":"Castinetti","sequence":"additional","affiliation":[{"name":"Aix Marseille Universit\u00e9, INSERM, U1251, Department of Endocrinology, Marseille Medical Genetics (MMG), centre de r\u00e9f\u00e9rence des maladies rares de l\u2019hypophyse (HYPO), h\u00f4pital de la Conception, France, Assistance Publique-H\u00f4pitaux de Marseille (AP-HM), 13005 Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"DoCao","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, CHU Lille, 59000 Lille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3942-4276","authenticated-orcid":false,"given":"Laurence","family":"Amar","sequence":"additional","affiliation":[{"name":"Department of hypertension, AP-HP, H\u00f4pital Europ\u00e9en Georges Pompidou, 75015 Paris, France"},{"name":"Universit\u00e9 de Paris, INSERM, PARCC, Equipe labellis\u00e9e contre le cancer, F-75015 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julien","family":"Hadoux","sequence":"additional","affiliation":[{"name":"Endocrine Oncology Unit, Gustave Roussy, F-94805, Villejuif, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2228-0106","authenticated-orcid":false,"given":"Charlotte","family":"Lussey-Lepoutre","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Paris, INSERM, PARCC, Equipe labellis\u00e9e contre le cancer, F-75015 Paris, France"},{"name":"Sorbonne University, Department of Nuclear Medicine, AP-HP, Piti\u00e9-Salp\u00eatri\u00e8re, 75013 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2515-7840","authenticated-orcid":false,"given":"Fran\u00e7oise","family":"Borson-Chazot","sequence":"additional","affiliation":[{"name":"F\u00e9d\u00e9ration d\u2019endocrinologie, H\u00f4pital Louis Pradel, Hospices Civils de Lyon, EA 7425, Universit\u00e9 Lyon1, 69500 Lyon, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Delphine","family":"Vezzosi","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, CHU Toulouse, 40031 Toulouse, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Delphine","family":"Drui","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, L\u2019institut du thorax, 44200 CHU Nantes, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandrine","family":"Laboureau","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, CHU Angers, 49933 Angers, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie-Laure","family":"Raffin Sanson","sequence":"additional","affiliation":[{"name":"Department of Endocrinology&Nutrition, AP-HP, H\u00f4pital Ambroise Par\u00e9, 92100 Boulogne-Billancourt, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Livia","family":"Lamartina","sequence":"additional","affiliation":[{"name":"Endocrine Oncology Unit, Gustave Roussy, F-94805, Villejuif, 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France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne-Paule","family":"Gimenez-Roqueplo","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Paris, INSERM, PARCC, Equipe labellis\u00e9e contre le cancer, F-75015 Paris, France"},{"name":"Assistance Publique H\u00f4pitaux de Paris, H\u00f4pital europ\u00e9en Georges Pompidou, Service de G\u00e9n\u00e9tique, F-75015 Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arnaud","family":"Jannin","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, CHU Lille, 59000 Lille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Leboulleux","sequence":"additional","affiliation":[{"name":"Endocrine Oncology Unit, Gustave Roussy, F-94805, Villejuif, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carole","family":"Guerin","sequence":"additional","affiliation":[{"name":"Aix Marseille University, 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