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Cited by 286Adrenal and Paraganglionic TumorsRenal cell carcinoma treatmentNeuroendocrine Tumor Research Advances

Laparoscopic versus open adrenalectomy for adrenocortical carcinoma: surgical and oncologic outcome in 152 patients

Brix, David, Allolio, Bruno, Fenske, Wiebke, Agha, Ayman, Dralle, Henning, Jurowich, Christian, Langer, Peter, Mussack, Thomas +6 more·2010·European Urology
DOI 10.1016/j.eururo.2010.06.024
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Abstract

Background The role of laparoscopic adrenalectomy in the treatment of patients with adrenocortical carcinoma (ACC) is controversial.Objective Our aim was to compare oncologic outcome in patients with ACC who underwent either open adrenalectomy (OA) or laparoscopic adrenalectomy (LA) for localised disease.Design, setting, and participants We conducted a retrospective analysis of 152 patients with stage I-III ACC with a tumour < or =10 cm registered with the German ACC Registry.Intervention Patients were stratified into two groups according to the surgical procedure (LA or OA). For comparison, we used both a matched pairs approach by selecting for each patient from the LA group (n=35) one corresponding patient from the OA group (n=117) and multivariate analysis in all 152 patients.Measurements Disease-specific survival was chosen as the predefined primary end point. Secondary end points were recurrence-free survival, frequency of tumour capsule violation and postoperative peritoneal carcinomatosis, and incidence and reasons for conversion from LA to OA.Results and limitations LA and OA did not differ with regard to the primary end point using either the matched pairs approach (hazard ratio [HR] for death: 0.79; 95% confidence interval [CI], 0.36-1.72; p=0.55) or multivariate analysis (HR for death: 0.98; 95% CI, 0.51-1.92; p=0.92). Similarly, adjusted recurrence-free survival was not different between LA and OA (HR: 0.91; 95% CI, 0.56-1.47; p=0.69). Frequency of tumour capsule violation and peritoneal carcinomatosis were comparable between groups. In 12 of 35 patients of the LA group, surgery was converted to open surgery with no impact on the clinical outcome.Conclusions For localised ACC with a diameter of < or =10 cm, LA by an experienced surgeon is not inferior to OA with regard to oncologic outcome.

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Crossref · 10.1016/j.eururo.2010.06.024

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  • In the German ACC Registry case-control study, 37% of all patients had no data regarding margin status.

    “and 37% of all patients had no data regarding margin status.”

    From Adrenocortical carcinoma (2014) · cites this paper as [261]

  • In the German ACC Registry case-control study, 3 times as many OA patients had stage 3 disease and only 4 LA patients (11%) had stage 3 disease, potentially introducing bias toward more advanced disease in the OA group.

    “However, 3 times as many patients in the OA group had stage 3 disease and only 4 patients (11%) undergoing LA were found to have stage 3 disease, potentially introducing a bias toward more advanced disease in the OA group”

    From Adrenocortical carcinoma (2014) · cites this paper as [261]

  • A case-control study from the German ACC Registry Group reported no difference in overall or disease-free survival, tumor capsule violation, or peritoneal carcinomatosis among 117 patients undergoing OA and 35 patients undergoing LA for stage 1 to 3 ACCs less than 10 cm.

    “A case-control study from the German ACC Registry Group reported no difference in overall or disease-free survival, tumor capsule violation, or peritoneal carcinomatosis among 117 patients undergoing OA and 35 patients undergoing LA for stage 1 to 3 ACCs less than 10 cm (261).”

    From Adrenocortical carcinoma (2014) · cites this paper as [261]

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Authors
Brix, D., Allolio, B., Fenske, W., Agha, A., Dralle, H., Jurowich, C., Langer, P., Mussack, T., Nies, C., Riedmiller, H., Spahn, M., Weismann, D., Hahner, S., & Fassnacht, M.
Affiliations
  • University of Würzburg (DE)
  • University Hospital Regensburg (DE)
  • University Hospital in Halle (DE)
  • Philipps University of Marburg (DE)
  • Ludwig-Maximilians-Universität München (DE)
  • Marienhospital Osnabrück (DE)
Corresponding author
  • Allolio, Bruno
  • Fassnacht, Martin
ORCID
Venue
European Urology
Publisher
Elsevier BV
Published
2010-10
Volume
58
Issue
4
Pages
609-615
ISSN
0302-2838 (ISSN-L)
DOI
10.1016/j.eururo.2010.06.024
OpenAlex
W1966536771
Cited by
286
References
28
Citations by year
2026: 5 · 2025: 10 · 2024: 10 · 2023: 11 · 2022: 9 · 2021: 15 · 2020: 12 · 2019: 15 · 2018: 21 · 2017: 12 · 2016: 21 · 2015: 30 · 2014: 33 · 2013: 18 · 2012: 32
FWCI
27.37
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • European Urology (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 technique comparison, disease-specific survival, recurrence-free survival, peritoneal carcinomatosis, conversion to open surgery
MeSH terms
Adrenal Cortex Neoplasms, Adrenalectomy, Adult, Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Laparoscopy, Retrospective Studies, Treatment Outcome, Adrenocortical Carcinoma, Young Adult

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