Laparoscopic or Open Adrenalectomy for Stage I–II Adrenocortical Carcinoma: A Retrospective Study

Author:

Gaillard Martin1ORCID,Razafinimanana Meva1,Challine Alexandre2,Araujo Raphael L. C.3,Libé Rossella4,Sibony Mathilde5,Barat Maxime6ORCID,Bertherat Jérôme4,Dousset Bertrand1,Fuks David1,Gaujoux Sebastien7

Affiliation:

1. Department of Digestive, Hepatobiliary and Endocrine Surgery, Hôpital Cochin, APHP.Centre, 75014 Paris, France

2. Department of Digestive Surgery, Hôpital Saint-Antoine, APHP.Sorbonne Université, 75012 Paris, France

3. Department of Surgery, Hospital Israelita Albert Einstein, Universidade Federal de Sao Paulo, Sao Paulo 05652-900, Brazil

4. Department of Endocrinology, Hôpital Cochin, APHP.Centre, 75014 Paris, France

5. Department of Pathology, Hôpital Cochin, APHP.Centre, 75014 Paris, France

6. Department of Radiology, Hôpital Cochin, APHP.Centre, 75014 Paris, France

7. Department of Hepato-Biliary and Pancreatic Surgery and Liver Transplantation, Hôpital Pitié-Salpêtrière, APHP.Sorbonne Université, 75013 Paris, France

Abstract

Surgical resection of adrenocortical carcinoma (ACC) is the only curative treatment. Even in localized (I–II) stages, open adrenalectomy (OA) is the gold standard, though laparoscopic adrenalectomy (LA) can be proposed in selected patients. Despite the postoperative benefits of LA, its role in the surgical management of patients with ACC remains controversial regarding oncologic outcomes. The aim of this retrospective study was to compare the outcomes of patients with localized ACC submitted to LA or OA in a referral center from 1995 to 2020. Among 180 consecutive patients operated on for ACC, 49 presented with localized ACC (19 LA and 30 OA). Baseline characteristics were similar between groups, except for tumor size. Kaplan-Meier estimates of 5-year overall survival were similar in both groups (p = 0.166) but 3-year disease-free survival was in favor of OA (p = 0.020). Though LA could be proposed in highly selected patients, OA should still be considered the standard approach in patients with known or suspected localized ACC.

Publisher

MDPI AG

Subject

General Medicine

Reference40 articles.

1. Update in adrenocortical carcinoma;Fassnacht;J. Clin. Endocrinol. Metab.,2013

2. Adrenocortical carcinoma: A population-based study on incidence and survival in the Netherlands since 1993;Kerkhofs;Eur. J. Cancer (Oxf. Engl. 1990),2013

3. Adrenocortical carcinoma;Else;Endocr. Rev.,2014

4. Laparoscopic adrenalectomy in Cushing’s syndrome and pheochromocytoma;Gagner;N. Engl. J. Med.,1992

5. Laparoscopic adrenalectomy;Assalia;Br. J. Surg.,2004

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