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An R-Based Landscape Validation of a Competing Risk Model
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Symptomatic Pheochromocytoma: A Risk Model.
María Consuelo Muñoz1, Beatriz Febrero2,3,4, Miriam Abellán2
1Hospital Comarcal del Noroeste, 30400 Murcia, Spain.
Cancers
|February 13, 2026
Summary
Symptomatic pheochromocytoma (PHEO) is linked to sex, genetics, and hormone profile, increasing perioperative risks. A predictive nomogram aids in managing patients with this rare tumor.
Area of Science:
- Endocrinology
- Surgical Oncology
- Genetics
Background:
- Pheochromocytoma (PHEO) diagnosis is increasing via incidental findings and genetic screening.
- Predictors of symptomatic PHEO presentation and associated perioperative risks are not well-defined.
Purpose of the Study:
- Quantify symptomatic PHEO prevalence.
- Identify factors associated with symptomatic presentation.
- Compare perioperative outcomes between symptomatic and asymptomatic PHEO.
- Develop a predictive nomogram for symptomatic PHEO risk.
Main Methods:
- Retrospective analysis of 173 PHEO patients (1984-2021).
- Logistic regression to assess associations with symptomatic presentation.
- Nomogram construction and evaluation using ROC analysis (AUC).
Main Results:
- 67.1% of patients were symptomatic.
- Male sex and germline mutations decreased symptom likelihood; noradrenergic profile increased it.
- Symptomatic PHEO correlated with higher intraoperative and postoperative complication rates.
- The nomogram showed moderate predictive discrimination (AUC 0.799).
Conclusions:
- Symptomatic PHEO presentation is influenced by sex, genetic status, and secretion profile.
- Symptomatic PHEO is associated with increased perioperative morbidity.
- A predictive nomogram using available variables can aid risk assessment and perioperative management.
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