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Cited by 74Adrenal and Paraganglionic TumorsRenal cell carcinoma treatmentHormonal Regulation and Hypertension

Long-term outcome following laparoscopic adrenalectomy for large solid adrenal cortex tumors

Palazzo, F. Fausto, Sebag, Frederic, Sierra, Mauricio, Ippolito, Giuseppe, Souteyrand, Philippe, Henry, Jean‐François·2006·World Journal of Surgery
DOI 10.1007/s00268-005-0288-2
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Abstract

INTRODUCTION: Laparoscopic adrenalectomy (LA) is the procedure of choice for small benign adrenal tumors. In the absence of local invasion or metastases, the preoperative diagnosis of an adrenocortical carcinoma (ACC) is difficult, often leaving size as the principal predictor of malignancy. Large tumors are resectable laparoscopically, but the long-term outcome and therefore appropriateness of LA for cortical tumors > 6 cm is not known. METHODS: We reviewed the LA experience in our institution since its introduction in June 1994. Patients who underwent LA for solid cortical tumors > or = 60 mm in diameter without preoperative or intraoperative evidence of malignancy were reviewed. Follow-up data, including clinical examination, biochemical analysis, and repeat scans, were reviewed for evidence of local or systemic recurrent disease. RESULTS: Between 1994 and 2004 a total of 462 adrenalectomies were performed, 391 of which were done laparoscopically. Among them, 19 were solid cortical tumors > or = 60 mm in diameter with no overt malignant preoperative or intraoperative characteristics: 9 nonsecreting tumors, 8 Cushing's syndrome tumors (including 2 virilizing variants), 1 virilizing tumor, and 1 aldosteronoma. The mean age of the patients was 49.9 years (range 22-77 years), and the mean tumor size was 69.0 mm (range 60-80 mm). Histology confirmed a cortical adenoma in eight patients, malignant tumors in three, and indeterminate tumors in eight. The mean follow-up was 34 months (range 4-108 months). Two patients died of systemic recurrent disease (liver metastases) at 10 and 19 months, respectively, following surgery; two other patients died 12 and 21 months, respectively following surgery owing to unrelated cardiovascular and cerebrovascular pathology. One patient underwent surgery for local recurrence 54 months after primary surgery; the remaining 14 patients are well with no clinical or radiologic evidence of recurrent disease. CONCLUSIONS: Laparoscopic adrenalectomy for large solid cortical tumors without pre- or intraoperative evidence of malignancy is not contraindicated, and it is unlikely to have a deleterious effect on long-term outcome. Each case should be considered individually. We provide an algorithm for the approach to adrenocortical tumors > or = 6 cm.

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Crossref · 10.1007/s00268-005-0288-2

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  • LA may be technically feasible even for large tumors.

    “although LA may be technically feasible (even for large tumors) (263, 264)”

    From Adrenocortical carcinoma (2014) · cites this paper as [264]

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Authors
Palazzo, F. F., Sebag, F., Sierra, M., Ippolito, G., Souteyrand, P., & Henry, J.
Affiliations
Hôpital de la Timone (FR)
Corresponding author
Henry, Jean‐François
ORCID
Venue
World Journal of Surgery
Publisher
Wiley
Published
2006-04-17
Volume
30
Issue
5
Pages
893-898
ISSN
  • 0364-2313 (ISSN-L)
  • 1432-2323
DOI
10.1007/s00268-005-0288-2
OpenAlex
W2101906664
Cited by
74
References
34
Citations by year
2020: 2 · 2019: 4 · 2018: 2 · 2017: 7 · 2016: 2 · 2015: 6 · 2014: 2 · 2013: 6 · 2012: 9
FWCI
7.39
Type
journal article
Language
en
Open access
closed
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • World Journal of Surgery (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Surgery › Adrenal and Paraganglionic Tumors
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Renal cell carcinoma treatment
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal Regulation and Hypertension
Keywords
laparoscopic adrenalectomy, large adrenal tumors, adrenocortical carcinoma, adrenal adenoma, tumor size, long-term outcomes, recurrence, Cushing's syndrome, virilizing adrenal tumor, aldosterone-producing adenoma, liver metastasis, surgical indications, follow-up algorithm, adrenal insufficiency
MeSH terms
Adrenal Cortex Neoplasms, Adrenalectomy, Adult, Aged, Algorithms, Humans, Middle Aged, Neoplasm Staging, Laparoscopy, Retrospective Studies, Time Factors, Treatment Outcome, Adrenocortical Adenoma, Adrenocortical Carcinoma

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