title: Assessment of the Aldosteronona resolution score as a predictive resolution score of hypertension after adrenalectomy for aldosteronoma in French patients.
abstract: OBJECTIVE
  Aldosteronoma Resolution Score (ARS) is a predictive score for cure of hypertension after adrenalectomy for hyperaldosteronism and has been validated in American patients. The aim of the study was to validate this score in a French population.
  
  
  METHODS
  Data concerning patients operated from 2002 to 2015 in 7 French University Hospitals were retrospectively collected. Diagnosis of Aldosterone-producing adenoma (APA) was confirmed with clinical and biochemical hyperaldosteronism and adrenal nodule on CT scan. Adrenal venous sampling was performed when CT failed to identify laterality. ARS is based on four variables: female sex, BMI ≤25 kg/m2, duration of hypertension ≤6 years, number of antihypertensive medications ≤2. One point is attributed for the first three and 2 points for the last. Patients were considered as cured if they had no hypertension and no antihypertensive medications at least 6 months after surgery. Patients with bilateral adrenal hyperplasia were excluded.
  
  
  RESULTS
  This multicenter study included 310 patients with APA. ARS and follow-up were obtained in 257 patients. 46.6% of patients were cured and potassium serum level was normalized in 97.7%. In multivariate analysis, odds ratio for female sex, BMI ≤25 kg/m2, duration of hypertension ≤6 years, and number of antihypertensive medications ≤2 were 1.60 (p = 0.09), 1.77 (p = 0.04), 1.28 (p = 0.4), 3.41 (p < 0.001), respectively. Cure rate were, respectively, 22.2, 41.4 and 74% for patients with a score ARS 0-1, 2-3, 4-5. The area under the curve (AUC) of ARS was 0.715.
  
  
  CONCLUSIONS
  ARS is not a predictive score efficient enough in a French population maybe due to different metabolic data and genetic conditions.
authors.affiliation: Clinique de Chirurgie Digestive et Endocrinienne (CCDE), Institut des Maladies de l'Appareil Digestif (IMAD), CHU Hôtel-Dieu, 1 place Alexis Ricordeau, 44093, Nantes cedex 1, France.
authors.forename: Ludwig
authors.initials: L
authors.lastname: Pasquier
authors.affiliation: Service de chirurgie Générale, Viscérale et Endocrinienne, Hôpital Universitaire Pitié Salpêtrière, Paris, France.
authors.forename: Medhi
authors.initials: M
authors.lastname: Kirouani
authors.affiliation: Service de Chirurgie Endocrinienne et Générale, Centre Hospitalier Lyon Sud, Lyon, France.
authors.forename: Florian
authors.initials: F
authors.lastname: Fanget
authors.affiliation: Service de Chirurgie Digestive, Hépatobiliaire, Pancréatique, Endocrinienne et Cancérologique, CHRU de Nancy, Nancy, France.
authors.forename: Claire
authors.initials: C
authors.lastname: Nomine
authors.affiliation: Clinique de Chirurgie Digestive et Endocrinienne (CCDE), Institut des Maladies de l'Appareil Digestif (IMAD), CHU Hôtel-Dieu, 1 place Alexis Ricordeau, 44093, Nantes cedex 1, France.
authors.forename: Cécile
authors.initials: C
authors.lastname: Caillard
authors.affiliation: Service de Chirurgie Digestive Endocrinienne et Transplantation Hépatique, CHRU de Tours, Tours, France.
authors.forename: Vincent
authors.initials: V
authors.lastname: Arnault
authors.affiliation: Service de Chirurgie Viscérale et Endocrinienne, CHU d'Angers, Angers, France.
authors.forename: Jean-Baptiste
authors.initials: JB
authors.lastname: Finel
authors.affiliation: Service de Chirurgie Digestive, Générale et Endocrinienne, CHU Limoges, Limoges, France.
authors.forename: Niki
authors.initials: N
authors.lastname: Christou
authors.affiliation: Service de Chirurgie Digestive, Générale et Endocrinienne, CHU Limoges, Limoges, France.
authors.forename: Muriel
authors.initials: M
authors.lastname: Mathonnet
authors.affiliation: Service de chirurgie Générale, Viscérale et Endocrinienne, Hôpital Universitaire Pitié Salpêtrière, Paris, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Trésallet
authors.affiliation: Service de Chirurgie Viscérale et Endocrinienne, CHU d'Angers, Angers, France.
authors.forename: Antoine
authors.initials: A
authors.lastname: Hamy
authors.affiliation: Service de Chirurgie Digestive Endocrinienne et Transplantation Hépatique, CHRU de Tours, Tours, France.
authors.forename: Loïc
authors.initials: L
authors.lastname: de Calan
authors.affiliation: Service de Chirurgie Digestive, Hépatobiliaire, Pancréatique, Endocrinienne et Cancérologique, CHRU de Nancy, Nancy, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Brunaud
authors.affiliation: Service de chirurgie Générale, Viscérale et Endocrinienne, Hôpital Universitaire Pitié Salpêtrière, Paris, France.
authors.forename: Fabrice
authors.initials: F
authors.lastname: Menegaux
authors.affiliation: Service de Chirurgie Endocrinienne et Générale, Centre Hospitalier Lyon Sud, Lyon, France.
authors.forename: Jean Christophe
authors.initials: JC
authors.lastname: Lifante
authors.affiliation: Biomathematiques, Biostatistiques et Informatique, Faculté de Médecine, Université de Nantes, Nantes, France.
authors.forename: Jean Benoit
authors.initials: JB
authors.lastname: Hardouin
authors.affiliation: Service d'Endocrinologie, CHU Nantes, Nantes, France.
authors.forename: Delphine
authors.initials: D
authors.lastname: Drui
authors.affiliation: Clinique de Chirurgie Digestive et Endocrinienne (CCDE), Institut des Maladies de l'Appareil Digestif (IMAD), CHU Hôtel-Dieu, 1 place Alexis Ricordeau, 44093, Nantes cedex 1, France.
authors.forename: Éric
authors.initials: É
authors.lastname: Mirallié
authors.affiliation: Clinique de Chirurgie Digestive et Endocrinienne (CCDE), Institut des Maladies de l'Appareil Digestif (IMAD), CHU Hôtel-Dieu, 1 place Alexis Ricordeau, 44093, Nantes cedex 1, France. claire.blanchard@chu-nantes.fr.
authors.forename: Claire
authors.identifier: http://orcid.org/0000-0001-6801-7018
authors.initials: C
authors.lastname: Blanchard
mesh_terms: D000236:Adenoma / Q000097:blood / Q000150:complications / Q000601:surgery*; D000293:Adolescent; D000310:Adrenal Gland Neoplasms / Q000097:blood / Q000150:complications / Q000601:surgery*; D000315:Adrenalectomy; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000450:Aldosterone / Q000097:blood; D005260:Female; D005602:France; D006801:Humans; D006929:Hyperaldosteronism / Q000150:complications* / Q000175:diagnosis / Q000601:surgery*; D006973:Hypertension / Q000097:blood* / Q000150:complications / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000450:Aldosterone
keywords: Adrenalectomy; Aldosterone producing adenoma; Aldosteronoma resolution score; Hypertension