Long-Term Survival After Adrenalectomy for Stage I/II Adrenocortical Carcinoma (ACC): A Retrospective Comparative Cohort Study of Laparoscopic Versus Open Approach

Donatini, Gianluca; Caïazzo, Robert; Cao, Christine Do; Aubert, Sébastien; Zerrweck, Carlos; El-Kathib, Ziad; Gauthier, Thomas; Leteurtre, Emmanuelle; Wémeau, Jean-Louis; Vantyghem, Marie-Christine; Carnaille, B.; Pattou, François

doi:10.1245/s10434-013-3164-6

Cited by 110 publications

(93 citation statements)

References 52 publications

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“…Nine cohort studies on the surgical treatment of patients with nonmetastatic adrenocortical carcinoma were included (151,152,153,154,155,156,157,158,159). Three studies reported on the patients in whom complete resection of the tumor was achieved (153,155,159).…”

Section: Surgical Approach: Open Vs Minimally Invasive Adrenalectomy mentioning

confidence: 99%

“…These studies also provided data on overall or disease-specific survival (151,152,153,154,155,157,158,159). There is no compelling evidence that one of the approaches (laparoscopic or open adrenalectomy) is superior with regard to time to recurrence and/or survival in patients with adrenocortical carcinoma, provided that rupture of tumor capsule is excluded.…”

Section: Recurrence-free and Overall Survivalmentioning

confidence: 99%

See 1 more Smart Citation

Management of adrenal incidentalomas: European Society of Endocrinology Clinical Practice Guideline in collaboration with the European Network for the Study of Adrenal Tumors

Fassnacht

Arlt

Bancos

et al. 2016

European Journal of Endocrinology

1,335

1,571

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By definition, an adrenal incidentaloma is an asymptomatic adrenal mass detected on imaging not performed for suspected adrenal disease. In most cases, adrenal incidentalomas are nonfunctioning adrenocortical adenomas, but may also represent conditions requiring therapeutic intervention (e.g. adrenocortical carcinoma, pheochromocytoma, hormone-producing adenoma or metastasis). The purpose of this guideline is to provide clinicians with best possible evidence-based recommendations for clinical management of patients with adrenal incidentalomas based on the GRADE (Grading of Recommendations Assessment, Development and Evaluation) system. We predefined four main clinical questions crucial for the management of adrenal incidentaloma patients, addressing these four with systematic literature searches: (A) How to assess risk of malignancy?; (B) How to define and manage low-level autonomous cortisol secretion, formerly called 'subclinical' Cushing's syndrome?; (C) Who should have surgical treatment and how should it be performed?; (D) What follow-up is indicated if the adrenal incidentaloma is not surgically removed? Selected recommendations: (i) At the time of initial detection of an adrenal mass establishing whether the mass is benign or malignant is an important aim to avoid cumbersome and expensive follow-up imaging in those with benign disease. (ii) To exclude cortisol excess, a 1 mg overnight dexamethasone suppression test should be performed (applying a cut-off value of serum cortisol ≤50 nmol/L (1.8 µg/dL)). (iii) For patients without clinical signs of overt Cushing's syndrome but serum cortisol levels post 1 mg dexamethasone >138 nmol/L (>5 µg/dL), we propose the term 'autonomous cortisol secretion'. (iv) All patients with '(possible) autonomous cortisol' secretion should be screened for hypertension and type 2 diabetes mellitus, to ensure these are appropriately treated. (v) Surgical treatment should be considered in an individualized approach in patients with 'autonomous cortisol secretion' who also have comorbidities that are potentially related to cortisol excess. (vi) In principle, the appropriateness of surgical intervention should be guided by the likelihood of malignancy, the presence and degree of hormone excess, age, general health and patient preference. (vii) Surgery is not usually indicated in patients www.eje-online.org European Journal of Endocrinology175:2 G2 Clinical Practice Guideline M Fassnacht and others ESE and ENSAT guideline on adrenal incidentalomawith an asymptomatic, nonfunctioning unilateral adrenal mass and obvious benign features on imaging studies. We provide guidance on which surgical approach should be considered for adrenal masses with radiological findings suspicious of malignancy. Furthermore, we offer recommendations for the follow-up of patients with adrenal incidentaloma who do not undergo adrenal surgery, for those with bilateral incidentalomas, for patients with extra-adrenal malignancy and adrenal masses and for young and elderly patients with adrenal inciden...

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Section: Surgical Approach: Open Vs Minimally Invasive Adrenalectomy mentioning

confidence: 99%

Section: Recurrence-free and Overall Survivalmentioning

confidence: 99%

Management of adrenal incidentalomas: European Society of Endocrinology Clinical Practice Guideline in collaboration with the European Network for the Study of Adrenal Tumors

Fassnacht

Arlt

Bancos

et al. 2016

European Journal of Endocrinology

1,335

1,571

View full text Add to dashboard Cite

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“…Traditionally, if ACC was recognized intraoperatively, conversion to an open procedure was mandated, since the laparoscopic approach had been linked to increased local recurrence, tumor seeding at port sites, and peritoneal spread. A recent study, however, has shown no diference in long-term oncological outcomes in carefully selected patients with stage I/II ACC, tumors <10 cm, and no evidence of extra-adrenal invasion, who underwent laparoscopic adrenalectomy by experienced surgeons [18].…”

Section: Adrenocortical Carcinomamentioning

confidence: 96%

Current Management of Adrenal Incidentalomas

Michailidou¹,

Guerrero²

2017

Clinical Management of Adrenal Tumors

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Adrenal "incidentalomas" refer to a group of adrenal masses initially discovered during cross-sectional imaging obtained for other clinical reasons. The majority of incidentalomas are benign nonfunctional adrenal adenomas and can be safely managed expectantly. A subset of adrenal incidentalomas, however, are functional and/or malignant, and these lesions most often require adrenalectomy. The following chapter outlines the diferential diagnosis, the diferent imaging modalities and features, as well as biochemical evaluation of adrenal incidentalomas.

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“…In literature there are many publications comparing both methods and their complications, radical oncological therapy, duration of the operation, blood loss, and hospitalisation time. In most cases, the laparoscopic method seems to be better than the open procedure [7,8]. The surgical technique must be adjusted to the patients' needs.…”

Section: Introductionmentioning

confidence: 99%

The usefulness of laparoscopic adrenalectomy in the treatment of adrenal neoplasms — a single-centre experience

Pogorzelski

Toutounchi

Krajewska

et al. 2017

Endokrynologia Polska

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Introduction: Adrenal neoplasms comprise about 10% of all tumours affecting this organ and constitute a significant, at first diagnostic and subsequently therapeutic, problem, especially since a relatively high proportion of neoplastic lesions are asymptomatic. The number of diagnosed metastases to adrenal glands is increasing. Surgical treatment involves both open surgery as well as laparoscopy. Material and methods: There were 245 adrenalectomies performed at our centre due to various indications over the past four years. In 27 (11.5%) cases neoplasms were diagnosed in the final histopahtological examination. In 11 (40.7%) cases primary adrenal cortex tumours were diagnosed, metastases from other solid organ tumours were identified in another 12 (44.4%) patients, and rarer neoplasms were diagnosed in the remaning 4 (14.8%) subjects. Cases of malignant pheochromocytoma were not included in this report.

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Long-Term Survival After Adrenalectomy for Stage I/II Adrenocortical Carcinoma (ACC): A Retrospective Comparative Cohort Study of Laparoscopic Versus Open Approach

Cited by 110 publications

References 52 publications

Management of adrenal incidentalomas: European Society of Endocrinology Clinical Practice Guideline in collaboration with the European Network for the Study of Adrenal Tumors

Management of adrenal incidentalomas: European Society of Endocrinology Clinical Practice Guideline in collaboration with the European Network for the Study of Adrenal Tumors

Current Management of Adrenal Incidentalomas

The usefulness of laparoscopic adrenalectomy in the treatment of adrenal neoplasms — a single-centre experience

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