The DOI matches its Crossref record; 39 of the 39 references it cites were found in a registry or an index.
Impact of Lymphadenectomy on the Oncologic Outcome of Patients With Adrenocortical Carcinoma
Abstract
OBJECTIVE: Adrenocortical carcinoma (ACC) is a rare malignancy with an unfavorable prognosis. The impact of a locoregional lymph node dissection (LND) has never been defined in this disease. We report the disease-specific outcome of patients treated with or without LND during primary adrenalectomy. METHODS: The medical records of patients followed by the German ACC Registry were retrospectively reviewed. Patients with incomplete resection or distant metastases were excluded. Only if the histologic analysis retrieved 5 or more lymph nodes, an intended LND was assumed (LND group). The predefined primary end point of the study was disease-specific survival. RESULTS: Of 283 included patients, 47 patients (16.6%) were treated with LND, whereas 236 patients (83.4%) underwent surgery without LND. Patients who underwent LND had a larger median tumor size (12.0 cm, range: 2.3-30 cm vs 10.0 cm, range: 4.0-39 cm, P = 0.007) and were more often treated by multivisceral resection (LND: 47.8% vs no-LND: 18.1%; P < 0.001). The other baseline characteristics (age, sex, endocrine activity, Weiss score, Ki-67 index, and adjuvant treatment) did not differ significantly. Median follow-up of all patients still alive was 40 months (range: 6-326). Multivariate analysis adjusted for age, tumor stage, multivisceral resection, adjuvant treatment, and lymph nodes status on preoperative imaging demonstrated a significantly reduced risk for tumor recurrence (hazard ratio: 0.65; 95% confidence interval: 0.43-0.98; P = 0.042) and for disease-related death (hazard ratio: 0.54; 95% confidence interval: 0.29-0.99; P = 0.049) in LND patients when compared with no-LND patients. CONCLUSIONS: Our retrospective data indicate that locoregional LND improves tumor staging and leads to a favorable oncologic outcome in patients with localized ACC.
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“Furthermore, there is emerging evidence from the surgical literature that adequate lymph node dissection at the time of adrenalectomy likely improves both rates of disease recurrence and survival (249).”
From Adrenocortical carcinoma (2014) · cites this paper as [249]
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Metadata
- Authors
- Reibetanz, J., Jurowich, C., Erdogan, I., Nies, C., Rayes, N., Dralle, H., Behrend, M., Allolio, B., & Fassnacht, M.
- Affiliations
- University of Würzburg (DE)
- Marienhospital Osnabrück (DE)
- Charité – Universitätsmedizin Berlin (DE)
- University Hospital in Halle (DE)
- Corresponding author
- Reibetanz, Joachim
- Jurowich, Christian
- Venue
- Annals of Surgery
- Published
- 2012-02
- Volume
- 255
- Issue
- 2
- Pages
- 363-369
- ISSN
- 0003-4932 (ISSN-L)
- OpenAlex
- W2074531404
- Cited by
- 176
- References
- 39
- Citations by year
- 2026: 4 · 2025: 9 · 2024: 8 · 2023: 10 · 2022: 8 · 2021: 17 · 2020: 11 · 2019: 9 · 2018: 14 · 2017: 13 · 2016: 14 · 2015: 20 · 2014: 13 · 2013: 10 · 2012: 13
- FWCI
- 12.33
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Annals of Surgery (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Julius-Maximilians-Universität Würzburg
- Topics
- Health Sciences › Medicine › Surgery › Adrenal and Paraganglionic Tumors
- Health Sciences › Medicine › Oncology › Renal cell carcinoma treatment
- Health Sciences › Medicine › Oncology › Neuroendocrine Tumor Research Advances
- Keywords
- adrenocortical carcinoma, lymph node dissection, adrenalectomy, disease-specific survival, tumor recurrence, multivisceral resection, tumor staging, oncological outcomes
- MeSH terms
- Adolescent, Adrenal Cortex, Adrenal Cortex Neoplasms, Adult, Aged, Aged, 80 and over, Child, Child, Preschool, Female, Humans, Infant, Lymph Node Excision, Lymphatic Metastasis, Male, Middle Aged, Neoplasm Staging, Recurrence, Retrospective Studies, Survival Analysis, Treatment Outcome, Adrenocortical Carcinoma, Young Adult
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