This is a retrospective review of 217 patients (156 patients with stage I-III cancer) with adrenocortical carcinoma referred to a single institution between 2005 and 2011. Outcome and operative data were assessed for the subset undergoing resection with curative intent. Student
One hundred fifty-six patients (64 % female; median age, 47 years [range, 18-80]; median follow-up, 26.5 months [range, 1-188]) were identified. Forty-six patients underwent laparoscopic adrenalectomy, and 110 underwent open adrenalectomy. Twenty-seven percent of laparoscopic adrenalectomy patients had stage III cancer. After laparoscopic adrenalectomy, 30 % had positive margins or intraoperative tumor spill compared to 16 % of the open adrenalectomy patients (
Open adrenalectomy is superior to laparoscopic adrenalectomy for adrenocortical carcinoma based on completeness of resection, site and timing of initial tumor recurrence, and survival in stage II patients. Intraoperative evaluation is insensitive for the detection of stage III tumors.