An Analysis of Computed Tomography Imaging Features and Predictive Factors for Postoperative Recurrence and Metastasis of Abdominal Paragangliomas

Abstract

Background and Objectives. Recurrence and metastasis are the most important factors influencing the survival rate of patients with paragangliomas (PGLs). Accurate preoperative prediction of the risk factors and developing a reasonable therapy strategy can reduce the recurrence rate. Computed tomography (CT) is regarded as the preferred imaging modality for the initial evaluation of PGLs. However, only a few studies have investigated the relationship between CT features and the invasiveness of PGLs. Therefore, we investigated the prognostic importance of CT features for PGLs. Methods. We studied 51 abdominal PGL patients at the First Affiliated Hospital of Bengbu Medical College, Tongde Hospital, and Sir Run Shaw Hospital, Hangzhou, Zhejiang Province, China, from June 2009 to May 2019. Thereafter, the clinical research data, tumor biomarkers, and CT features were compared between the aggressive PGLs and the nonaggressive PGLs using independent-samples t-tests and chi-square tests. Results. Of the 51 cases, 43 were benign and 8 had malignant tendencies. Postoperative recurrence and metastasis were more likely to occur when the tumor diameter was >8 cm or/and the enhancement degree was not obvious. Clinical symptoms, tumor markers, sex, age, and CT image characteristics including morphology, presence of cystic degeneration, “pointed peach” sign, calcification, hemorrhage, enlarged lymph nodes, and peritumor and intratumor blood vessels were not significantly different between the two groups $\left(p>0.05\right)$ . Conclusion. Our findings suggest that CT features, including size >8 cm and enhancement degree, could provide important evidence to assess risk factors for aggressive PGLs.