Byung-Chang Kim

Objective: Pheochromocytoma is increasingly diagnosed at the extremes of age due to the availability of genetic screening in young patients and incidental detection on imaging in older patients. The aim of this study was to assess the effect of age on presentation and outcomes after adrenalectomy for pheochromocytoma. Methods: A retrospective international multicenter cohort study was performed on patients undergoing adrenalectomy for pheochromocytoma between 2012 and 2022 in 49 centers. Patients were divided into three cohorts: ≤40, 41–59, and ≥60 years old. Univariate and multivariate analyses were used to compare cohorts and assess the impact of age on postoperative outcomes. Results: Of the 2,301 included patients, 551 were ≤40 years (23.9%), 969 were between 41 and 59 years (42.1%), and 781 were ≥60 years (33.9%). Younger cohorts were more likely to have a genetic syndrome (≤40 years 29.4% vs 41–59 years 11.5% vs ≥60 years 6.2%, P < 0.001) and bilateral tumors (10.2 vs 2.3 vs 1.3%, P < 0.001). On multivariable analysis, overall complications seemed less frequent in older cohorts (adjusted odds ratio (aOR): 0.64, P = 0.012, and aOR: 0.66, P = 0.054, for 41–59 and ≥60 years versus ≤40 years), while there were no clear trends in severe complications (Clavien–Dindo grade 3a–5) (aOR: 0.81, P = 0.481, and aOR: 0.78, P = 0.486, respectively) or comprehensive complication index (beta coefficient: −1.49, P = 0.046, and −1.66, P = 0.083, respectively). Conclusion: Age is associated with significant differences in presentation in patients undergoing adrenalectomy for pheochromocytoma, but does not have a clear association with postoperative complications. Pheochromocytoma postoperative morbidity is more likely affected by ‘high-risk’ disease rather than exclusively by age.

Background: Robotic thyroidectomy has been increasingly adopted as a minimally invasive approach, with feasibility and safety established using existing robotic platforms. Materials and Methods: We report the first experimental application of the HUGO Robotic‐Assisted Surgery (RAS) system for thyroidectomy via a transaxillary approach in a porcine model. Results: All procedural steps, from flap creation to thyroid gland dissection, were completed successfully without technical difficulties. The presumed recurrent laryngeal nerve was identified and preserved throughout the procedure. Conclusions: This preclinical study demonstrates the technical feasibility of thyroidectomy using the HUGO RAS system. These findings support its applicability in human thyroid surgery and future clinical translation.

Chung SY, et al. J Endocr Surg. 2026 Mar;26(1):9-20. https://doi.org/10.16956/jes.2026.26.1.9

Kwon D, et al. Ann Surg Treat Res. 2026 Mar;110(3):149-156. https://doi.org/10.4174/astr.2026.110.3.149

Background: Oncocytic adrenocortical neoplasms (OANs) are extremely rare adrenal tumors whose diagnosis is challenging. This study aimed to identify risk factors for predicting poor prognosis in patients with OAN of uncertain malignant potential (OANUMP) and oncocytoma, OAN subtypes, and to evaluate the diagnostic utility of the current Lin-Weiss-Bisceglia (LWB) criteria. Methods: We retrospectively reviewed 14 patients diagnosed with OANUMP or oncocytoma after adrenalectomy from February 2002 to May 2022. Patients re-classified as oncocytic adrenocortical carcinoma by the LWB criteria were excluded. We compared the clinicopathological and radiological features between patients with and without recurrence. Results: Among the 14 patients, recurrence occurred in 3 (21%; 2 (67%) and 1 (33%) patients with OANUMP and oncocytoma, respectively). The proportion of patients with necrosis (66.7% vs 9.1%, p = 0.093), a Helsinki score >5 (66.7% vs 9.1%, p = 0.093), and malignancy by the reticulin algorithm (66.7% vs 9.1%, p = 0.093) were higher in the recurrence group than in the no-recurrence group but were not statistically significant. The percentages of patients with an indeterminate pathological resection margin (100% vs 63.6%, p = 0.192) tended to be higher in the recurrence group than in the no-recurrence group. Of the three patients with recurrence, two had tumor necrosis on the final pathology and were classified as malignant by the reticulin algorithm. One patient diagnosed as OANUMP by the LWB criteria had tumor necrosis and was classified as malignant by the reticulin algorithm and Helsinki scoring system. Conclusion: Necrosis was associated with the recurrence of disease in patients with OANUMP according to the LWB criteria. The absence of necrosis as a major criterion in the current LWB criteria highlights its potential limitation in accurately assessing disease aggressiveness in OANs.

Background: The necessity of prophylactic central lymph node dissection (p-CLND) in patients with clinically node-negative papillary thyroid carcinoma (PTC) is unclear. The present study evaluated the central lymph node (LN) metastases status in patients with clinically node-negative PTC on both preoperative thyroid ultrasonography (USG) and neck computed tomography (CT) who underwent p-CLND. Methods: This retrospective cohort study included 3002 clinically node-negative patients diagnosed with PTC who had undergone thyroidectomy with p-CLND from January 2000 to September 2022. Clinically node-negative was defined as the absence of suspicious metastatic LNs on preoperative USG and neck CT. Low-risk central LN metastases were defined as LN metastases p = 0.012). Factors independently associated with intermediate-/high-risk central LN metastases included age 1 cm on USG (OR = 1.94), and the presence of extrathyroidal extension on CT scans (OR = 1.53), with p < 0.001 for all factors. Conclusions: Most LNs confirmed after CLND in cN0 PTC patients assessed by USG and CT were either metastasis-free or classified as low-risk metastatic LNs. Furthermore, the majority of metastatic LNs were small in size, typically measuring <1 cm. p-CLND may be unnecessary if preoperative thyroid USG and neck CT show no evidence of central neck LN metastaes.

Kwon D, et al. J Endocr Surg. 2025 Sep;25(3):109-117. https://doi.org/10.16956/jes.2025.25.3.109

Kwon D, et al. Ann Surg Treat Res. 2024 Oct;107(4):187-194. https://doi.org/10.4174/astr.2024.107.4.187

Kim BC, et al. Ann Surg Treat Res. 2024 Jan;106(1):38-44. https://doi.org/10.4174/astr.2024.106.1.38

Kim BC, et al. J Endocr Surg. 2022 Dec;22(4):116-122. https://doi.org/10.16956/jes.2022.22.4.116