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Open vs laparoscopic adrenalectomy for localized adrenocortical carcinoma
Author(s) -
Kastelan Darko,
Knezevic Nikola,
Zibar Tomsic Karin,
Alduk AnaMarija,
Kakarigi Luka,
Kastelan Marko,
Coric Marijana,
SkoricPolovina Tanja,
Solak Mirsala,
Kraljevic Ivana,
Balasko Annemarie,
Gnjidic Milena,
Dusek Tina
Publication year - 2020
Publication title -
clinical endocrinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.055
H-Index - 147
eISSN - 1365-2265
pISSN - 0300-0664
DOI - 10.1111/cen.14251
Subject(s) - medicine , adrenocortical carcinoma , retrospective cohort study , adrenalectomy , stage (stratigraphy) , laparoscopy , surgery , carcinoma , overall survival , laparoscopic surgery , gastroenterology , urology , paleontology , biology
Objective The purpose of the study was to compare the long‐term outcomes of patients with localized adrenocortical carcinoma (ACC) subjected to open vs laparoscopic surgery. Design Retrospective study. Patients This retrospective study included 46 patients with the ACC ENSAT stage I‐stage III of whom 23 underwent open surgery (OA group), whereas 23 were subjected to laparoscopic adrenalectomy (LA group). The main outcomes analysed in the study were differences between the OA and LA groups in recurrence‐free survival (RFS) and overall survival (OS). Results Patients in OA group had larger tumours (120 [70‐250] mm vs 75 [26‐110] mm; P < .001), higher Ki‐67 index (16 [1‐65] % vs 10 [1‐25] %; P = .04) and higher disease stage ( P = .01) compared with the patients in the LA group. The median duration of follow‐up for patients underwent OA and LA was 51 (12‐174) and 53 (5‐127) months, respectively. Eight patients (5 OA and 3 LA) experienced recurrent disease, whereas six patients (3 OA and 3 LA) died during follow‐up. No differences in RFS and OS were found between patients who underwent open or laparoscopic surgery. Conclusion The study demonstrated that in patients with localized ACC and without invasion of extra‐adrenal tissues, LA is a plausible treatment option in terms of RFS and OS. However, our results are limited to referral centres with large experience in the management of patients with ACC and may not necessarily apply to nonspecialized centres.