Impact of gender on the prognosis of carotid body tumor after surgical resection

Abstract

Background Carotid body tumors (CBTs) are rare neuroendocrine neoplasms, but the prognosis of patients with resected CBTs has seldom been elucidated. This study was conducted to investigate the association between variables, especially sex, and the prognosis of carotid body tumor resection. Methods This was a large-volume single-center retrospective cohort study. Patients who were diagnosed with CBTs between 2009 and 2020 at our center were analyzed retrospectively. Their preoperative, surgical, and follow-up data were collected, and the association between variables and outcomes of CBT resection was assessed by correlation analysis, multivariate logistic regression, and multivariate Cox regression as appropriate. Results A total of 326 patients (66.6% were females) were included. Males developed larger CBTs than females (4.3 ± 1.8 cm vs. 3.8 ± 1.4 cm, P = .003). Males were more likely to develop succinate dehydrogenase B (SDHB) mutations (P = .019) and had worse relapse-free survival rates (P = .024). Although tumor size and Shamblin classification had positive relationships with neurological complications and intraoperative blood loss, they did not affect the overall survival rate of patients, which was only influenced by remote metastasis (P = .007) and local recurrence (P = .008). Conclusions Compared to females, males with CBT resection were found to have more SDHB mutations and worse relapse-free survival rates, which may lead to the deterioration of prognosis. Tumor size and Shamblin classification cannot predict the overall survival rate of patients with excised CBTs. Graphical abstract

Multidisciplinary care improves outcomes for patients with carotid body paragangliomas—The UCLA experience

“…In addition to greater risk of neurological complications, a positive correlation between Shamblin grade or tumor size and intraoperative blood loss has previously been reported 22 . This trend is in accordance with what we observed in our cohort, in which there was a corresponding 99 mL increase in EBL for every 10 mm increase in CBT diameter ( R 2 = 0.94).…”

“…In addition to greater risk of neurological complications, a positive correlation between Shamblin grade or tumor size and intraoperative blood loss has previously been reported. 22 This trend is in accordance with what we observed in our cohort, in which there was a corresponding 99 mL increase in EBL for every 10 mm increase in CBT diameter (R 2 = 0.94). In a systematic review of 465 patients who underwent CBT surgery and embolization by Economopoulos et al, the average EBL was 368 mL with an average tumor size of 49 mm.…”

“… 15 Based on previous literature, overall survival rate is primarily influenced by remote metastasis and local recurrence. 22 , 23 Given that adverse events were not drastically different between surgical specialties, we maintain that multidisciplinary surgeries have similar or better outcomes in CBT resections when compared to OHNS or vascular surgery alone.…”

Five-year outcome of a staged giant Shamblin type III carotid body tumor excision

“… 15 The identification of genetic components of the disease are especially important because mortality for these patients has been found to be influenced by recurrence and metastasis rather than the tumor size or Shamblin type. 16 …”