Skip to main content
Springer Nature Link
Log in

Prevention of serious skeletal-related events by interventional radiology techniques in patients with malignant paraganglioma and pheochromocytoma

  • Original Article
  • Published:
Endocrine Aims and scope Submit manuscript

Abstract

Purpose

Bone metastases (BM) and skeletal-related events (SRE) are frequent in patients with malignant pheochromocytoma and paraganglioma (PPM) and the best modality of prevention unknown. The role of interventional radiology (IR) techniques for the prevention of SRE in the multidisciplinary management of malignant PPM has not been evaluated in that setting.

Methods

Single referral center retrospective review of all patients with malignant PPM with BM from 2000 to 2016. The primary endpoint was the time to first serious SRE (TTSRE). At time of inclusion, patients with high bone tumor burden disease were defined as those having more than five BM with the biggest exceeding 2 cm (Group A) and patients with moderate bone tumor burden disease were defined as those having five or less BM or no BM exceeding 2 cm (Group B).

Results

A total of 28 patients were included in this study. Thirteen were treated by IR techniques for prevention of first serious SRE. After a median follow-up of 48.2 months, the median TTSRE was not reached in patients treated by IR techniques and was 26.0 months in patients without IR procedures (p = .058). When comparing patients in group B, TTSRE was significantly higher in patients treated by IR (10 patients) when compared to patients without IR procedures (12 patients) (p = .021).

Conclusions

IR techniques may help to delay the occurrence of first serious SRE in patients with malignant PPM with moderate bone tumor burden disease. Prospective studies are expected to confirm these results.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

Abbreviations

BM:

Bone metastasis

SRE:

Skeletal-related event

PPM:

Paragangliomas and pheochromocytomas

IR:

Interventional radiology

TTSRE:

Time to first serious SRE

FDG:

18F-fluorodeoxyglucose

PET:

Positron emission tomography

CT:

Computed tomography

DFI:

Disease-free interval

LFU:

Last follow-up

MIBG:

Metaiodobenzylguanidine

PV:

Percutaneous vertebroplasty

PO:

Percutaneous osteosynthesis

References

  1. H. Chen, R.S. Sippel, M.S. O’Dorisio, A.I. Vinik, R.V. Lloyd, K. Pacak, and North American Neuroendocrine Tumor Society (NANETS), The North American Neuroendocrine Tumor Society consensus guideline for the diagnosis and management of neuroendocrine tumors: pheochromocytoma, paraganglioma, and medullary thyroid cancer. Pancreas 39, 775 (2010)

    Article  Google Scholar 

  2. L. Amar, M. Fassnacht, A.-P. Gimenez-Roqueplo, A. Januszewicz, A. Prejbisz, H. Timmers, P.-F. Plouin, Long-term postoperative follow-up in patients with apparently benign pheochromocytoma and paraganglioma. Horm. Metab. Res. 44, 385–9 (2012)

    Article  CAS  Google Scholar 

  3. G. Eisenhofer, S.R. Bornstein, F.M. Brouwers, N.-K.V. Cheung, P.L. Dahia, R.R. de Krijger, T.J. Giordano, L.A. Greene, D.S. Goldstein, H. Lehnert, W.M. Manger, J.M. Maris, H.P.H. Neumann, K. Pacak, B.L. Shulkin, D.I. Smith, A.S. Tischler, W.F. Young, Malignant pheochromocytoma: current status and initiatives for future progress. Endocr. Relat. Cancer 11, 423 (2004)

    Article  CAS  Google Scholar 

  4. L. Amar, E. Baudin, N. Burnichon, S. Peyrard, S. Silvera, J. Bertherat, X. Bertagna, M. Schlumberger, X. Jeunemaitre, A.-P. Gimenez-Roqueplo, P.-F. Plouin, Succinate dehydrogenase B gene mutations predict survival in patients with malignant pheochromocytomas or paragangliomas. J. Clin. Endocrinol. Metab. 92, 3822 (2007)

    Article  CAS  Google Scholar 

  5. M. Ayala-Ramirez, J.L. Palmer, M.-C. Hofmann, M. de la Cruz, B.S. Moon, S.G. Waguespack, M.A. Habra, C. Jimenez, Bone metastases and skeletal-related events in patients with malignant pheochromocytoma and sympathetic paraganglioma. J. Clin. Endocrinol. Metab. 98, 1492 (2013)

    Article  CAS  Google Scholar 

  6. H.J.L.M. Timmers, C.C. Chen, J.A. Carrasquillo, M. Whatley, A. Ling, G. Eisenhofer, K.S. King, J.U. Rao, R.A. Wesley, K.T. Adams, K. Pacak, Staging and functional characterization of pheochromocytoma and paraganglioma by 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography. J. Natl. Cancer Inst. 104, 700 (2012)

    Article  CAS  Google Scholar 

  7. S. Hescot, S. Leboulleux, L. Amar, D. Vezzosi, I. Borget, C. Bournaud-Salinas, C. de la Fouchardiere, R. Libé, C. Do Cao, P. Niccoli, A. Tabarin, I. Raingeard, C. Chougnet, S. Giraud, A.-P. Gimenez-Roqueplo, J. Young, F. Borson-Chazot, J. Bertherat, J.-L. Wemeau, X. Bertagna, P.-F. Plouin, M. Schlumberger, E. Baudin, and French group of Endocrine and Adrenal tumors (Groupe des Tumeurs Endocrines-REseau NAtional des Tumeurs ENdocrines and COrtico-MEdullo Tumeurs Endocrines networks), One-year progression-free survival of therapy-naive patients with malignant pheochromocytoma and paraganglioma. J. Clin. Endocrinol. Metab. 98, 4006 (2013)

    Article  CAS  Google Scholar 

  8. J.H. Lee, F. Barich, L.H. Karnell, R.A. Robinson, W.K. Zhen, B.J. Gantz, H.T. Hoffman, American College of Surgeons Commission on Cancer, and American Cancer Society, National Cancer Data Base report on malignant paragangliomas of the head and neck. Cancer 94, 730 (2002)

    Article  Google Scholar 

  9. F. Deschamps, G. Farouil, T. de Baere, Percutaneous ablation of bone tumors. Diagn. Interv. Imaging 95, 659 (2014)

    Article  CAS  Google Scholar 

  10. F. Deschamps, T. de Baere, A. Hakime, E. Pearson, G. Farouil, C. Teriitehau, L. Tselikas, Percutaneous osteosynthesis in the pelvis in cancer patients. Eur. Radiol. 26, 1631 (2016)

    Article  Google Scholar 

  11. F. Deschamps, T. de Baere, Cementoplasty of bone metastases. Diagn. Interv. Imaging 93, 685 (2012)

    Article  CAS  Google Scholar 

  12. F. Deschamps, G. Farouil, N. Ternes, A. Gaudin, A. Hakime, L. Tselikas, C. Teriitehau, E. Baudin, A. Auperin, T. de Baere, Thermal ablation techniques: a curative treatment of bone metastases in selected patients? Eur. Radiol. 24, 1971 (2014)

    Article  CAS  Google Scholar 

  13. U.S. Department of Health and Human Services. National Institutes of Health. (National Cancer Institute: Common Terminology Criteria for Adverse Events (CTCAE) Version 4. 03, 2010), https://evs.nci.nih.gov/ftp1/CTCAE/CTCAE_4.03_2010-06-14_QuickReference_5x7.pdf. Accessed 7 Sept 2017

  14. Y. Kanda, Investigation of the freely available easy-to-use software ‘EZR’ for medical statistics. Bone Marrow Transplant. 48, 452 (2013)

    Article  CAS  Google Scholar 

  15. K. Van Loon, L. Zhang, J. Keiser, C. Carrasco, K. Glass, M.-T. Ramirez, S. Bobiak, E.K. Nakakura, A.P. Venook, M.H. Shah, E.K. Bergsland, Bone metastases and skeletal-related events from neuroendocrine tumors. Endocr. Connect. 4, 9 (2015)

    Article  Google Scholar 

  16. M.O. Baerlocher, W.E. Saad, S. Dariushnia, J.D. Barr, J.K. McGraw, B. Nikolic; and Society of Interventional Radiology Standards of Practice Committee, Quality improvement guidelines for percutaneous vertebroplasty. J. Vasc. Interv. Radiol. 25, 165 (2014)

    Article  Google Scholar 

  17. A. Cotten, N. Boutry, B. Cortet, R. Assaker, X. Demondion, D. Leblond, P. Chastanet, B. Duquesnoy, H. Deramond, Percutaneous vertebroplasty: state of the art. Radiographics 18, 311 (1998)

    Article  CAS  Google Scholar 

  18. D.A. Palma, J.K. Salama, S.S. Lo, S. Senan, T. Treasure, R. Govindan, R. Weichselbaum, The oligometastatic state—separating truth from wishful thinking. Nat. Rev. Clin. Oncol. 11, 549 (2014)

    Article  Google Scholar 

  19. Z. Wang, D. Qiao, Y. Lu, D. Curtis, X. Wen, Y. Yao, H. Zhao, Systematic literature review and network meta-analysis comparing bone-targeted agents for the prevention of skeletal-related events in cancer patients with bone metastasis. Oncologist 20, 440 (2015)

    Article  CAS  Google Scholar 

  20. O. Sartor, R. Coleman, S. Nilsson, D. Heinrich, S.I. Helle, J.M. O’Sullivan, S.D. Fosså, A. Chodacki, P. Wiechno, J. Logue, A. Widmark, D.C. Johannessen, P. Hoskin, N.D. James, A. Solberg, I. Syndikus, N.J. Vogelzang, C.G. O’Bryan-Tear, M. Shan, Ø.S. Bruland, C. Parker, Effect of radium-223 dichloride on symptomatic skeletal events in patients with castration-resistant prostate cancer and bone metastases: results from a phase 3, double-blind, randomised trial. Lancet Oncol. 15, 738 (2014).

    Article  CAS  Google Scholar 

Download references

Author information

Author notes

  1. Eric Baudin and Frederic Deschamps contributed equally to this work.

Authors and Affiliations

  1. Department of Interventional Radiology, Gustave Roussy Cancer Center, 114 rue Edouard Vaillant, 94805, Villejuif, France

    Guillaume Gravel, Lambros Tselikas, Mohamed Berraf, Bakar Ba, Thierry de Baere & Frederic Deschamps

  2. Department of Nuclear Medicine and Endocrine Oncology, Gustave Roussy Cancer Center, 114 rue Edouard Vaillant, 94805, Villejuif, France

    Sophie Leboulleux, Flora Fassio, Amandine Berdelou, Segolene Hescot, Julien Hadoux, Martin Schlumberger & Eric Baudin

  3. Department of Anatomopathology, Gustave Roussy Cancer Center, 114 rue Edouard Vaillant, 94805, Villejuif, France

    Abir Al Ghuzlan

  4. Department of Radiotherapy, Gustave Roussy Cancer Center, 114 rue Edouard Vaillant, 94805, Villejuif, France

    France Nguyen

  5. Department of Surgery, Gustave Roussy Cancer Center, 114 rue Edouard Vaillant, 94805, Villejuif, France

    Mathieu Faron

Authors
  1. Guillaume Gravel
    View author publications

    You can also search for this author inPubMed Google Scholar

  2. Sophie Leboulleux
    View author publications

    You can also search for this author inPubMed Google Scholar

  3. Lambros Tselikas
    View author publications

    You can also search for this author inPubMed Google Scholar

  4. Flora Fassio
    View author publications

    You can also search for this author inPubMed Google Scholar

  5. Mohamed Berraf
    View author publications

    You can also search for this author inPubMed Google Scholar

  6. Amandine Berdelou
    View author publications

    You can also search for this author inPubMed Google Scholar

  7. Bakar Ba
    View author publications

    You can also search for this author inPubMed Google Scholar

  8. Segolene Hescot
    View author publications

    You can also search for this author inPubMed Google Scholar

  9. Julien Hadoux
    View author publications

    You can also search for this author inPubMed Google Scholar

  10. Martin Schlumberger
    View author publications

    You can also search for this author inPubMed Google Scholar

  11. Abir Al Ghuzlan
    View author publications

    You can also search for this author inPubMed Google Scholar

  12. France Nguyen
    View author publications

    You can also search for this author inPubMed Google Scholar

  13. Mathieu Faron
    View author publications

    You can also search for this author inPubMed Google Scholar

  14. Thierry de Baere
    View author publications

    You can also search for this author inPubMed Google Scholar

  15. Eric Baudin
    View author publications

    You can also search for this author inPubMed Google Scholar

  16. Frederic Deschamps
    View author publications

    You can also search for this author inPubMed Google Scholar

Corresponding author

Correspondence to Guillaume Gravel.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Gravel, G., Leboulleux, S., Tselikas, L. et al. Prevention of serious skeletal-related events by interventional radiology techniques in patients with malignant paraganglioma and pheochromocytoma. Endocrine 59, 547–554 (2018). https://doi.org/10.1007/s12020-017-1515-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12020-017-1515-y

Keywords

pFad - Phonifier reborn

Pfad - The Proxy pFad of © 2024 Garber Painting. All rights reserved.

Note: This service is not intended for secure transactions such as banking, social media, email, or purchasing. Use at your own risk. We assume no liability whatsoever for broken pages.


Alternative Proxies:

Alternative Proxy

pFad Proxy

pFad v3 Proxy

pFad v4 Proxy