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

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 s...

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Published in:Journal of clinical medicine 2023-05, Vol.12 (11), p.3698
Main Authors: Gaillard, Martin, Razafinimanana, Meva, Challine, Alexandre, Araujo, Raphael L C, Libé, Rossella, Sibony, Mathilde, Barat, Maxime, Bertherat, Jérôme, Dousset, Bertrand, Fuks, David, Gaujoux, Sebastien
Format: Article
Language:English
Subjects:
Adrenalectomy
Clinical medicine
Comparative analysis
Hormones
Laparoscopic surgery
Laparoscopy
Lymphatic system
Medical prognosis
Metastasis
Neuroendocrine tumors
Pathology
Patient outcomes
Patients
Regression analysis
Statistical analysis
Steroids
Surgeons
Surgery
Tomography
Tumors
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Summary: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 ( = 0.166) but 3-year disease-free survival was in favor of OA ( = 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.
ISSN:2077-0383
2077-0383
DOI:10.3390/jcm12113698