Predicting Metastatic Potential in Pheochromocytoma and Paraganglioma: A Comparison of PASS and GAPP Scoring Systems
Autor: | Virginia A. LiVolsi, Ezra Baraban, Katherine L. Nathanson, Lauren Fishbein, Douglas L. Fraker, Kathleen T. Montone, Lauren E. Schwartz, Debbie L. Cohen, Lauren N. Krumeich, Zubair W. Baloch, Heather Wachtel, Troy Hutchens |
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Rok vydání: | 2020 |
Předmět: |
Adult
Male medicine.medical_specialty Intraclass correlation Endocrinology Diabetes and Metabolism Clinical Biochemistry Adrenal Gland Neoplasms Pheochromocytoma Logistic regression Biochemistry Gastroenterology Cohort Studies Paraganglioma Surgical pathology Endocrinology Interquartile range Internal medicine Biomarkers Tumor medicine Humans Neoplasm Metastasis Online Only Articles Survival analysis Retrospective Studies Proportional hazards model business.industry Biochemistry (medical) Middle Aged Pennsylvania Prognosis medicine.disease Survival Analysis Research Design Female Neoplasm Grading business Follow-Up Studies |
Zdroj: | J Clin Endocrinol Metab |
ISSN: | 1945-7197 0021-972X |
Popis: | Purpose The Pheochromocytoma of the Adrenal Gland Scaled Score (PASS) and the Grading System for Adrenal Pheochromocytoma and Paraganglioma (GAPP) are scoring systems to predict metastatic potential in pheochromocytomas (PCC) and paragangliomas (PGLs). The goal of this study is to assess PASS and GAPP as metastatic predictors and to correlate with survival outcomes. Methods The cohort included PCC/PGL with ≥5 years of follow-up or known metastases. Surgical pathology slides were rereviewed. PASS and GAPP scores were assigned. Univariable and multivariable logistic regression, Kaplan–Meier survival analysis, and Cox proportional hazards were performed to assess recurrence-free survival (RFS) and disease-specific survival (DSS). Results From 143 subjects, 106 tumors were PCC and 37 were PGL. Metastases developed in 24%. The median PASS score was 6.5 (interquartile range [IQR]: 4.0-8.0) and median GAPP score was 3.0 (IQR: 2.0-4.0). Interrater reliability was low–moderate for PASS (intraclass correlation coefficient [ICC]: 0.6082) and good for GAPP (ICC 0.7921). Older age (OR: 0.969, P = .0170) was associated with longer RFS. SDHB germline pathogenic variant (OR: 8.205, P = .0049), extra-adrenal tumor (OR: 6.357, P Conclusion Higher GAPP scores were associated with aggressive PCC/PGL. PASS score was not associated with metastases and demonstrated significant interobserver variability. Scoring systems for predicting metastatic PCC/PGL may be improved by incorporation of histopathology, clinical data, and germline and somatic tumor markers. |
Databáze: | OpenAIRE |
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