Open versus endoscopic adrenalectomy in the treatment of localized (stage I/II) adrenocortical carcinoma: Results of a multiinstitutional Italian survey

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• 作者：Celestino Pio Lombardi ; MD^a ; Marco Raffaelli ; MD^a ; ^{marcoraffaelli@rm.unicatt.it} ; Carmela De Crea ; MD^a ; Marco Boniardi ; MD^b ; Giorgio De Toma ; MD^c ; Luigi Antonio Marzano ; MD^d ; Paolo Miccoli ; MD^e ; Francesco Minni ; MD^f ; Mario Morino ; MD^g ; Maria Rosa Pelizzo ; MD^h ; Andrea Pietrabissa ; MDⁱ ; Andrea Renda ; MD^j ; Andrea Valeri ; MD^k ; Rocco Bellantone ; MD^a
• 刊名：Surgery
• 出版年：2012
• 出版时间：December, 2012
• 年：2012
• 卷：152
• 期：6
• 页码：1158-1164
• 全文大小：176 K

文摘

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Background

We compared the oncologic effectiveness of open adrenalectomy and endoscopic adrenalectomy in the treatment of patients with localized adrenocortical carcinoma.

Methods

One hundred fifty-six patients with localized adrenocortical carcinoma (stage I/II) who underwent R0 resection were included in an Italian multiinstitutional surgical survey. They were divided into 2 groups based on the operative approach (either conventional or endoscopic).

Results

One hundred twenty-six patients underwent open adrenalectomy and 30 patients underwent endoscopic adrenalectomy. The 2 groups were well matched for age, sex, lesion size, and stage (P = NS). The mean follow-up time was similar for the 2 groups (P = NS). The local recurrence rate was 19 % for open adrenalectomy and 21 % for endoscopic adrenalectomy, whereas distant metastases were recorded in 31 % of patients in the conventional adrenalectomy group and 17 % in the endoscopic adrenalectomy group (P = NS). The mean time to recurrence was 27 ¡À 27 months in the conventional open adrenalectomy group and 29 ¡À 33 months in the endoscopic adrenalectomy group (P = NS). No significant differences were found between the 2 groups in?terms of 5-year disease-free survival (38.3 % vs 58.2 % ) and 5-year overall survival rates (48 % ?vs?67 % ; P = NS).

Conclusion

The operative approach does not affect the oncologic outcome of patients with localized?adrenocortical carcinoma, if the principles of surgical oncology are respected.