PD31-08 DEVELOPMENT OF AN EVIDENCE-BASED POSTOPERATIVE SURVEILLANCE GUIDELINE FOR PATIENTS WITH PHEOCHROMOCYTOMA

Abstract

INTRODUCTION AND OBJECTIVE: There is a risk of both local and metastatic recurrence following surgical resection of pheochromocytoma. Such recurrences can present many years after the initial treatment. Currently, there is no consensus on the testing methods, frequency of investigation, and duration of follow-up after surgical resection. The aim of this study is to develop an evidence-based clinical practice guideline for urologists addressing the postoperative surveillance of patients with pheochromocytoma. METHODS: A guideline committee of urologists, a geneticist, and an endocrinologist was created. PubMed, Medline, and the Cochrane Library databases were used for evidence synthesis, with a focus on systematic reviews, related guidelines and comparative studies examining the long-term follow-up of surgical patients with pheochromocytoma. Recommendations were developed using methodology consistent with GRADE (Grading of Recommendations, Assessment, Development and Evaluation). Particular importance was given to a European Society of Endocrinology guideline on this topic released in 2016 that was freely accessible with rigorous methodology. Many of the recommendations were adapted to a North American urology-specific context using the modified ADAPTE framework. RESULTS: Of the 11 recommendations from the European Society of Endocrinology, 2 were excluded as they were deemed not applicable, 4 were adopted with modifications to better suit a North American urologist’s context and 5 were adopted without modification. Other statements were based on a systematic review of the literature and one clinical principle was added. An algorithm summarizing the recommendations can be seen in Figure 1. CONCLUSIONS: Using the modified ADAPTE framework, we propose a urologist oriented guideline for the postoperative surveillance of resected pheochromocytoma. With the best available evidence, we developed a structured follow up algorithm for the timely identification of recurrent and metastatic disease.Source of Funding: None