Ablation versus laparoscopic adrenalectomy for the treatment of aldosterone‑producing adenoma: a meta-analysis

Chen, Jin; Wu, Juan; Zhu, Rui; Lu, Lu; Ma, Xiaohai

doi:10.1007/s00261-020-02887-8

Cited by 10 publications

(6 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Overall, the imaging-guided PA approach was found to be a safe approach to AM patient treatment, as evidenced by the low pooled local hemorrhage, pneumothorax, and hypertensive crisis rates (3%, 6%, and 6%, respectively). Hypertensive crisis is the most critical adverse event to consider when performing the PA-based treatment of adrenal disease, with incidence rates in the range of 15.2–67.5% for patients with primary adrenal tumors undergoing PA, particularly among pheochromocytoma patients [ 6 , 7 , 34 ]. In contrast, PA is much safer when used to treat AMs.…”

Section: Discussionmentioning

confidence: 99%

“…Technical success was defined by the completion of PA-based AM treatment as per the planned treatment protocol without any visible evidence of tumor enhancement on contrast-enhanced computed tomography (CT) or magnetic resonance imaging (MRI) performed 2–5 days after treatment, given that the targeted ablation zone in the surrounding fat tissue is difficult to detect on CT or MRI [ 8 , 9 ]. Hypertensive crisis was defined by systolic blood pressure ≥ 180 mm Hg or diastolic blood pressure ≥ 110 mm Hg [ 6 , 7 ].…”

Section: Methodsmentioning

confidence: 99%

“…While adrenalectomy can improve the survival of patients with isolated AMs [2][3][4][5], patients with some comorbidities are ineligible for this procedure [1]. Imaging-guided percutaneous ablation (PA) is often implemented as an alternative to adrenalectomy [6,7], with several studies having reported these two techniques to exhibit comparable levels of clinical efficacy for benign adrenal tumors, with PA additionally being associated with reduced intraoperative blood loss, a shorter operative duration, and more rapid postoperative recovery [6,7].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Percutaneous ablation for adrenal metastases: a systematic review and meta-analysis.

Zhang¹,

Fu²,

Wang³

2022

Videosurgery and Other Miniinvasive Techniques

View full text Add to dashboard Cite

Introduction: Imaging-guided percutaneous ablation (PA) is commonly employed for the treatment of patients diagnosed with adrenal metastasis (AM), but comprehensive analyses are essential to validate the efficacy and safety of this approach. Aim: The present meta-analysis was designed to evaluate the safety, efficacy, and long-term outcomes associated with the imaging-guided PA treatment of AM. Material and methods: Relevant studies in the PubMed, Embase, and Wanfang databases published as of June 2022 were identified, and pooled endpoint analyses were performed with Stata 12.0. Results: This meta-analysis included 15 studies. Overall, the respective pooled primary technical success, secondary technical success, local hemorrhage, pneumothorax, hypertension crisis, local recurrence, 1-year overall survival (OS), and 3-year OS rates in study participants were 88%, 93%, 3%, 6%, 6%, 19%, 80%, and 46%. High levels of heterogeneity were evident for the 1-year OS (I 2 = 79.6%) and 3-year OS endpoints (I 2 = 67.1%), but meta-regression analyses failed to identify predictors of these OS rates. Low heterogeneity was observed for subgroups of patients who had undergone cryoablation (I 2 = 0%) or patients with multiple primary cancers (I 2 = 0%) with respect to 1-year OS. Similarly, low heterogeneity for the 3-year OS endpoint was detected in subgroups of patients who had undergone cryoablation (I 2 = 0%), ultrasound-guided PA (I 2 = 0%), individuals with AMs secondary to hepatocellular carcinoma (I 2 = 0%), and patients with multiple primary cancers (I 2 = 0%).Conclusions: These results suggest imaging-guided PA to be a safe and effective treatment for AM associated with satisfactory long-term patient outcomes.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Percutaneous ablation for adrenal metastases: a systematic review and meta-analysis.

Zhang¹,

Fu²,

Wang³

2022

Videosurgery and Other Miniinvasive Techniques

View full text Add to dashboard Cite

show abstract

“…Percutaneous ablation strategies have been used to treat adrenal tumors, with 89 -100% complete ablation rates (11)(12)(13). Generally, ablation is less invasive and more cost-effective than LA (14).…”

Section: Introductionmentioning

confidence: 99%

Computed Tomography-Guided Cryoablation for Adrenal Metastasis Secondary to Non-small-cell Lung Cancer

Cheng

2021

Iran J Radiol

View full text Add to dashboard Cite

Background: Computed tomography (CT)-guided ablation has been used to treat adrenal metastasis (AM). However, the incidence of AM secondary to non-small-cell lung cancer (NSCLC) has not been investigated. Objectives: To assess the clinical efficacy of CT-guided cryoablation for treating AM secondary to NSCLC. Methods: This retrospective study was performed among patients with AM secondary to NSCLC, undergoing CT-guided cryoablation in our hospital. The rates of complete ablation, local recurrence, local recurrence-free survival (RFS), systematic RFS, and overall survival (OS) were also analyzed. Results: Thirty-four consecutive patients with AM secondary to NSCLC (16 cases of squamous cell carcinoma [SCC] and 18 cases of adenocarcinoma) underwent cryoablation in our hospital. The primary complete ablation rates were 93.8% and 88.9% in the SCC and adenocarcinoma groups, respectively (P = 1.000). Moderate blood pressure increases were observed in 7/34 (20.6%) patients during cryoablation. The local recurrence of AM was observed in five and three patients in the SCC and adenocarcinoma groups, respectively (P = 0.551). The median local RFS was 22 months in all patients, and there was no significant difference in terms of the local RFS between the SCC and adenocarcinoma groups (38 vs. 17 months) (P = 0.093). The median systematic RFS was 28 months in all patients, and the systematic RFS was significantly longer in the SCC group as compared to the adenocarcinoma group (56 vs. 19 months) (P = 0.001). The median OS was 34 months in all patients; it was significantly higher in the SCC group as compared to the adenocarcinoma group (56 vs. 22 months) (P = 0.009). Conclusion: CT-guided cryoablation can be a safe and effective treatment to control AM secondary to NSCLC.

show abstract

“…

To the editor, Chen et al [1] meta-analyzed the studies comparing radiofrequency ablation (RFA) with laparoscopic adrenalectomy (LA), which is currently held to be the gold standard for the surgical treatment of patients with primary aldosteronism (PA) due to unilateral aldosterone-producing adenoma (APA). They could include only five small non-randomized retrospective studies [2-6], and, moreover, their meta-analysis was affected by several methodological flaws and mistakes that, on the whole, question the validity of its results and the strength of its conclusions.First, prerequisites for including studies in a metaanalysis are a thorough check of their quality and exclusion of duplicated cases.

…”

mentioning

confidence: 99%

Letter to the editor on “Ablation versus laparoscopic adrenalectomy for the treatment of aldosterone-producing adenoma: a meta-analysis”

et al. 2021

View full text Add to dashboard Cite

To the editor, Chen et al. [1] meta-analyzed the studies comparing radiofrequency ablation (RFA) with laparoscopic adrenalectomy (LA), which is currently held to be the gold standard for the surgical treatment of patients with primary aldosteronism (PA) due to unilateral aldosterone-producing adenoma (APA). They could include only five small non-randomized retrospective studies [2-6], and, moreover, their meta-analysis was affected by several methodological flaws and mistakes that, on the whole, question the validity of its results and the strength of its conclusions.First, prerequisites for including studies in a metaanalysis are a thorough check of their quality and exclusion of duplicated cases. The study by Chen et al.[1] fell short on both these items. They could not include any prospective randomized trial and the quality assessment score used by the Authors [7] revealed that all studies included are high quality, but the Newcastle-Ottawa score (NOS)

show abstract

Ablation versus laparoscopic adrenalectomy for the treatment of aldosterone‑producing adenoma: a meta-analysis

Cited by 10 publications

References 24 publications

Percutaneous ablation for adrenal metastases: a systematic review and meta-analysis.

Percutaneous ablation for adrenal metastases: a systematic review and meta-analysis.

Computed Tomography-Guided Cryoablation for Adrenal Metastasis Secondary to Non-small-cell Lung Cancer

Letter to the editor on “Ablation versus laparoscopic adrenalectomy for the treatment of aldosterone-producing adenoma: a meta-analysis”

Contact Info

Product

Resources

About