Adrenocortical carcinoma surgery—surgical extent and approach

Vanbrugghe, Charles; Lowery, Aoife; Golffier, Claudio; Taïeb, David; Sébag, F.

doi:10.1007/s00423-016-1462-8

Cited by 18 publications

(14 citation statements)

References 29 publications

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“…This group argues that the extent of the resection is the important variable, and that if a complete resection with negative margins can be achieved using a laparoscopic approach, this is a viable option. 34 Case 2 in our series could be regarded as support for this opinion. In that case, a laparoscopic approach was attempted despite imaging consistent with malignancy, and the intervention successfully achieved negative margins.…”

Section: Discussionsupporting

confidence: 67%

The Spectrum of Large Adrenal Masses: A Case Series

Cooke-Barber¹,

Hatef²,

McGreal³

et al. 2020

HCA Healthcare Journal of Medicine

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Background Adrenocortical carcinoma (ACC) is a rare malignancy that is challenging to diagnose and has important implications for surgeons who approach this disease. Despite its rarity, it must always be in the differential diagnosis when investigating and treating large adrenal masses. We aim to demonstrate the complexities of this disease through a review of five recent patients at a single tertiary care center. Methods A series of five patients are described, each of whom presented to a single institution as referrals for "large adrenal mass" in the past sixteen months. Their pre-operative diagnosis, radiographic findings, the operative approach and the pathology results were examined. Results The first patient had a 12 cm high grade adrenocortical carcinoma. The second patient had pathology consistent with a 9 cm, high grade ACC. The third had a liposarcoma. The fourth patient had a myelolipoma. The fifth was diagnosed with a benign process. Conclusion Although adrenocortical carcinoma is an uncommon cancer, it has significant implications for the patient's prognosis and ultimately, their treatment algorithm. Therefore, when evaluating large adrenal masses, surgeons must remain vigilant of the possibility of adrenocortical carcinoma.

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Section: Discussionsupporting

confidence: 67%

The Spectrum of Large Adrenal Masses: A Case Series

Cooke-Barber¹,

Hatef²,

McGreal³

et al. 2020

HCA Healthcare Journal of Medicine

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“…The characterization of adrenal masses by imaging is a critical step to determine appropriate treatment and optimize prognosis. Adrenocortical carcinoma (ACC) is a rare and aggressive tumor for which comprehensive surgical resection presents the only curative option [1].…”

Section: Introductionmentioning

confidence: 99%

Characterization of adrenocortical tumors by 18F-FDG PET/CT: Does steroid hormone hypersecretion status modify the uptake pattern?

Paladino¹,

Guérin²,

Lowery³

et al. 2018

Surgical Oncology

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“…Furthermore, the accurate preoperative staging was important to select an appropriate surgical strategy. For large and potentially invasive ACC, multi-organ resection remained the preferentially selected approach; a more extensive resection was needed by patients with smaller ACC [31] . Based on our previous discussion, we can conclude that for the patient with ACC, surgical resection of the primary tumor can offer improved survival, irrespective of disease stage [32] .…”

Section: Discussionmentioning

confidence: 99%

Summary of clinical characteristics of common primary adrenal malignancies in adults

zhang¹,

wang²,

Li³

et al. 2020

Preprint

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Background To summary the clinical characteristics of common primary adrenal malignancies in adults, the survival time of the patients, and the prognostic factors associated with these rare malignancies. Methods The Surveillance, Epidemiology, and End Results database (1975–2016) was queried for all patients who were diagnosed with primary adrenal malignancies, including adrenocortical carcinoma(ACC), pheochromocytoma and paraganglioma (PPGL), lymphoma, and sarcoma (SA). The clinical characteristics, overall survival (OS) and cancer-specific survival (CSS) were analyzed, in which propensity score methodology, logistic regression modeling and Kaplan-Meier survival curves were used. The Multivariate Cox proportional hazard model was used to identify factors affecting the prognosis of patients with ACC. Results 3204 patients with primary adrenal malignancies were identified, including 2180 with ACC, 593 with PPGL, 307 with lymphoma, and 124 with SA. Generally, PPGL had a better prognosis than others. For ACC and PPGL, the non-metastatic group had better OS and CSS than the metastatic group; for SA, the non-metastatic group had better OS, however, there was no significant difference in CSS between the two groups. Furthermore, For ACC, the single metastasis group had a better OS than the multiple metastasis group. After tumors metastasis, the surgery group, surgery of primary adrenal lesions, had better OS and CSS than the non-surgery group for ACC and PPGL. For lymphoma, the chemotherapy group had better OS and CSS; for ACC and PPGL, the chemotherapy group had better CSS and worse OS; for SA, the survival showed no significant difference between the two groups. Radiotherapy had the same effect on patients' survival as chemotherapy, except for the lymphoma and the ACC. As for lymphoma, the radiotherapy group had better CSS, whereas the survival showed no significant difference in OS between the two groups. For ACC, the non- radiotherapy group had better CSS and OS. More importantly, for lymphoma, under the condition that both cohorts were the same basically, the surgical group had a better prognosis. The prognosis of ACC was related to sex, age, seer historic stage, surgery, chemotherapy. Conclusion Understanding the clinical characteristics of these tumors and factors affecting prognosis can facilitate the selection of more appropriate clinical treatment options.

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Adrenocortical carcinoma surgery—surgical extent and approach

Abstract: Accurate pre-operative staging is critical to select a tailored surgical strategy. Multi-organ resection remains the preferred approach for large and potentially invasive ACC. Some patients presenting with smaller ACC may benefit from a more extensive resection.

Cited by 18 publications

References 29 publications

The Spectrum of Large Adrenal Masses: A Case Series

The Spectrum of Large Adrenal Masses: A Case Series

Characterization of adrenocortical tumors by 18F-FDG PET/CT: Does steroid hormone hypersecretion status modify the uptake pattern?

Summary of clinical characteristics of common primary adrenal malignancies in adults

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