PERSPECTIVE: Challenging preoperative α-blockade in phaeochromocytoma surgery: beyond tradition, towards ‘safer surgery’

The rarity of phaeochromocytomas has left a gap in evidence supporting guideline recommendations for preoperative α-blockade dose-escalation. Despite recent studies questioning its efficacy, randomized-controlled trials (RCTs) are warranted before considering omitting preoperative α-blockade dose-es...

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Bibliographic Details
Published inEndocrine Connections Vol. 14; no. 5
Main Authors Holscher, Isabelle, Dreijerink, Koen M A, Hollmann, Markus W, van den Berg, Tijs J, Lubbers, Wouter D, Engelsman, Anton F, Nieveen van Dijkum, Els J M
Format Journal Article
LanguageEnglish
Published England Bioscientifica Ltd 01.05.2025
Bioscientifica
Subjects
Adrenal
adrenalectomy
alpha-blockade
Letter
phaeochromocytoma
survey
adrenalectomy
survey
phaeochromocytoma
alpha-blockade
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Summary:The rarity of phaeochromocytomas has left a gap in evidence supporting guideline recommendations for preoperative α-blockade dose-escalation. Despite recent studies questioning its efficacy, randomized-controlled trials (RCTs) are warranted before considering omitting preoperative α-blockade dose-escalation. Through an online survey, opinions on the ideal study design for this future RCT were gathered from specialists involved in phaeochromocytoma management in the Netherlands. Responses from 23 physicians suggest a non-inferiority-designed RCT that only excludes patients with severe comorbidities and incorporates clinical outcome measures as most suitable design. The survey furthermore revealed diverse opinions regarding study design and perioperative threats, emphasizing the importance of an inclusive, multidisciplinary approach in future research.
ISSN:2049-3614
2049-3614
DOI:10.1530/EC-25-0139