Outcome of operation in patients with adrenocortical cancer invading the inferior vena cava—a European Society of Endocrine Surgeons (ESES) survey

Mihai, Radu; Iacobone, Maurizio; Makay, Özer; Moreno, Pablo; Frilling, Andrea; Kraimps, Jean‐Louis; Soriano, Arturo; Moral, Jesús María Villar del; Barczyński, Marcin; Durán, Manuel; Sadler, Gregory P.; Niederle, Bruno; Dralle, Henning; Harrison, Barney; Carnaille, B.

doi:10.1007/s00423-011-0876-6

Cited by 42 publications

(26 citation statements)

References 12 publications

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“…26 ACC with extension into the renal vein, vena cava, or right atrium may require thrombectomy, cardiopulmonary bypass, hepatectomy for local spread or exposure, and vena cava reconstruction. 43,44,68,69 At the time of recurrence, surgery is recommended for patients with favorable prognostic factors, including a disease-free interval from previous surgery that is longer than 6 to 12 months, and achievable R0 resection. 31,32,40,[50][51][52] If not possible, surgery may be reconsidered at the time of objective response.…”

Section: Control Of Tumor Growthmentioning

confidence: 99%

“…22,29,41,42 Within the TNM staging system, ENSAT classification has been found to more accurately predict the outcome of patients with ACC, but recent studies suggest that the N status or severe vena cava invasion may behave like stage IV ACC, suggesting that refinements in the stratification of TNM are still needed. 16,25,29,43,44 Also, the relevance of stage I or II ENSAT subcategories is debated. 15,[17][18][19]22,23,42 Table 1 summarizes the evolution of TNM classifications in patients with ACC and new proposals based on recent studies.…”

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confidence: 99%

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Adrenocortical Carcinoma

Baudin

2015

Endocrinology and Metabolism Clinics of North America

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Recent developments in the treatment of adrenocortical carcinoma (ACC) include diagnostic and prognostic risk stratification algorithms, increasing evidence of the impact of historical therapies on overall survival, and emerging targets from integrated epigenomic and genomic analyses. Advances include proper clinical and molecular characterization of all patients with ACC, standardization of proliferative index analyses, referral of these patients to large cancer referral centers at the time of first surgery, and development of new trials in patients with well-characterized ACC. Networking and progress in the molecular characterization of ACC constitute the basis for significant future therapeutic breakthroughs.

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Section: Control Of Tumor Growthmentioning

confidence: 99%

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confidence: 99%

Adrenocortical Carcinoma

Baudin

2015

Endocrinology and Metabolism Clinics of North America

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“…The resection should include complete thrombectomy, a flush manoeuvre and, occasionally, vascular cuff or prosthetic IVC replacement. A 3‐year overall survival rate of 25–29 per cent in a large series encourages the performance of a venous resection in the presence of IVC or renal vein invasion.…”

Section: Optimal Surgical Approach To Non‐metastatic Primary Accmentioning

confidence: 96%

European Society of Endocrine Surgeons (ESES) and European Network for the Study of Adrenal Tumours (ENSAT) recommendations for the surgical management of adrenocortical carcinoma

Gaujoux

Mihai

Ensat

2017

British Journal of Surgery

163

133

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Background: Radical surgery provides the best chance of cure for adrenocortical carcinoma (ACC), but perioperative surgical care for these patients is yet to be standardized. Methods: A working group appointed jointly by ENSAT and ESES used Delphi methodology to produce evidence-based recommendations for the perioperative surgical care of patients with ACC. Papers were retrieved from electronic databases. Evidence and recommendations were classified according to the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system, and were discussed until consensus was reached within the group. Results: Twenty-five recommendations for the perioperative surgical care of patients with ACC were formulated. The quality of evidence is low owing to the rarity of the disease and the lack of prospective surgical trials. Multi-institutional prospective cohort studies and prospective RCTs are urgently needed and should be strongly encouraged. Conclusion: The present evidence-based recommendations provide comprehensive advice on the optimal perioperative care for patients undergoing surgery for ACC.

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“…Patients with metastatic disease amenable to complete surgical resection, for example liver or lung metastasis, should be considered for resection even if it is required to be completed over two stages 21,57,58. Complete surgical resection of recurrent disease in a medically fit and symptomatic patient can be of benefit and is associated with long-term survival in some patients 7,59. Any decision in offering radical surgical treatment is dependent on the tumor biology and will not offer any benefit for patients with rapidly progressive tumors 38…”

Section: Surgery and Other Local Treatmentsmentioning

confidence: 99%

Current management options for recurrent adrenocortical carcinoma

Glover¹,

Ip²,

Zhao³

et al. 2013

OTT

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Adrenal cortical carcinoma (ACC) is a rare cancer that poses a number of management challenges due to the limited number of effective systemic treatments. Complete surgical resection offers the best chance of long-term survival. However, despite complete resection, ACC is associated with high recurrence rates. This review will discuss the management of recurrent ACC in adults following complete surgical resection. Management should take place in a specialist center and treatment decisions must consider the individual tumor biology of each case of recurrence. Given the fact that ACC commonly recurs, management to prevent recurrence should be considered from initial diagnosis with the use of adjuvant mitotane. Close follow up with clinical examination and imaging is important for early detection of recurrent disease. Locoregional recurrence may be isolated, and repeat surgical resection should be considered along with mitotane. The use of radiotherapy in ACC remains controversial. Systemic recurrence most often involves liver, pulmonary, and bone metastasis and is usually managed with mitotane, with or without combination chemotherapy. There is a limited role for surgical resection in systemic recurrence in selected patients. In all patients with recurrent disease, control of excessive hormone production is an important part of management. Despite intensive management of recurrent ACC, treatment failure is common and the use of clinical trials and novel treatment is an important part of management.

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Outcome of operation in patients with adrenocortical cancer invading the inferior vena cava—a European Society of Endocrine Surgeons (ESES) survey

Cited by 42 publications

References 12 publications

Adrenocortical Carcinoma

Adrenocortical Carcinoma

European Society of Endocrine Surgeons (ESES) and European Network for the Study of Adrenal Tumours (ENSAT) recommendations for the surgical management of adrenocortical carcinoma

Current management options for recurrent adrenocortical carcinoma

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