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Cited by 221Adrenal and Paraganglionic TumorsRenal cell carcinoma treatmentNeuroendocrine Tumor Research Advances

Laparoscopic resection is inappropriate in patients with known or suspected adrenocortical carcinoma

Miller, B. S., Ammori, J. B., Gauger, P. G., Broome, J. T., Hammer, G. D., Doherty, G. M.·2010·World Journal of Surgery
DOI 10.1007/s00268-010-0532-2
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Abstract

BACKGROUND: Complete surgical resection is the mainstay of treatment for patients with adrenocortical cancer (ACC). Use of laparoscopy has been questioned in patients with ACC. This study compares the outcomes of patients undergoing laparoscopic versus open resection (OR) for ACC. METHODS: A retrospective review (2003-2008) of patients with ACC was performed. Data were collected for demographics, operative and pathologic data, adjuvant therapy, and outcome. Chi-square analysis was performed. RESULTS: Eighty-eight patients (66% women; median age, 47 (range, 18-81) years) were identified. Seventeen patients underwent laparoscopic adrenalectomy (LA). Median tumor size of those who underwent LA was 7.0 (range, 4-14) cm versus 12.3 (range, 5-27) cm for OR. Recurrent disease in the laparoscopic group occurred in 63% versus 65% in the open group. Mean time to first recurrence for those who underwent LA was 9.6 months (+/-14) versus 19.2 months (+/-37.5) in the open group (p < 0.005). Fifty percent of patients who underwent LA had positive margins or notation of intraoperative tumor spill versus 18% of those who underwent OR (p = 0.01). Local recurrence occurred in 25% of the laparoscopic group versus 20% in the open group (p = 0.23). Mean follow-up was 36.5 months (+/-43.6). CONCLUSIONS: ACC continues to be a deadly disease, and little to no progress has been made from a treatment standpoint in the past 20 years. Careful and complete surgical resection is of the utmost importance. Although feasible in many cases and tempting, laparoscopic resection should not be attempted in patients with tumors suspicious for or known to be adrenocortical carcinoma.

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Crossref · 10.1007/s00268-010-0532-2

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  • A University of Michigan retrospective study reviewed 88 ACC patients, 17 of whom underwent LA; 79% of operations were performed at outside facilities, and no laparoscopic operations for ACC were performed at the University of Michigan, potentially introducing referral bias.

    “A retrospective study from the University of Michigan reviewed 88 ACC patients, 17 of whom underwent LA, and 79% of the operations were performed at outside facilities, and no laparoscopic operations for ACC were performed at the University of Michigan, potentially introducing a referral bias (262).”

    From Adrenocortical carcinoma (2014) · cites this paper as [262]

  • In the University of Michigan study, there were more R1 or R2 resections or notation of intraoperative tumor spill in the LA group (50% vs 18%).

    “Furthermore, there were more R1 or R2 resections or notation of intraoperative tumor spill (50% vs 18%).”

    From Adrenocortical carcinoma (2014) · cites this paper as [262]

  • In the University of Michigan study, overall recurrence rates were similar between LA and OA.

    “Although overall recurrence rates were similar”

    From Adrenocortical carcinoma (2014) · cites this paper as [262]

  • In the University of Michigan study, despite on average smaller tumors in the LA group (7.0 cm) compared with the OA group (12.3 cm), the LA group had a significantly earlier recurrence (9.2 vs 19.2 months).

    “despite on average smaller tumors in the LA group (7.0 cm) compared with the OA group (12.3 cm), the LA group had a significantly earlier recurrence (9.2 vs 19.2 months).”

    From Adrenocortical carcinoma (2014) · cites this paper as [262]

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Authors
Miller, B. S., Ammori, J. B., Gauger, P. G., Broome, J. T., Hammer, G. D., & Doherty, G. M.
Affiliations
  • University of Michigan (US)
  • Vanderbilt University (US)
Corresponding author
Miller, B. S.
ORCID
Venue
World Journal of Surgery
Publisher
Wiley
Published
2010-04-07
Volume
34
Issue
6
Pages
1380-1385
ISSN
  • 0364-2313 (ISSN-L)
  • 1432-2323
DOI
10.1007/s00268-010-0532-2
OpenAlex
W2056135857
Cited by
221
References
18
Citations by year
2026: 3 · 2025: 5 · 2024: 6 · 2023: 10 · 2022: 6 · 2021: 12 · 2020: 11 · 2019: 13 · 2018: 15 · 2017: 16 · 2016: 17 · 2015: 22 · 2014: 22 · 2013: 16 · 2012: 19
FWCI
20.27
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 › Epidemiology › Neuroendocrine Tumor Research Advances
Keywords
adrenocortical carcinoma, laparoscopic adrenalectomy, open adrenalectomy, surgical resection, tumor recurrence, local recurrence, surgical margins, adjuvant therapy
MeSH terms
Contraindications, Adolescent, Adrenal Cortex Neoplasms, Adrenalectomy, Adult, Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Neoplasm Recurrence, Local, Neoplasm Staging, Laparoscopy, Retrospective Studies, Chi-Square Distribution, Treatment Outcome, Adrenocortical Carcinoma

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