Update on Adrenalectomy

Hayes, Galina

doi:10.1016/j.cvsm.2021.12.005

Cited by 7 publications

(13 citation statements)

References 32 publications

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“…Moreover, angiosarcoma is considered a high aggressive tumor, and its long-term survival showed poor prognosis with five-year survival rates ranging from 24% to 31% [ 2 , 4 , 9 ]. Regarding the management and the role of surgical resection, which is considered till now the treatment of choice, even though many factors need to be taken into account before proceeding to it [ 10 , 11 , 12 ], such as the size of the tumor, which showed only 2% of tumors <4 cm are found to be carcinosis while 6% of tumors < 6 cm and 25% of tumors >6 cm [ 13 ]. Regarding choosing the type of surgery, open surgery is still the standard for all patients with resectable tumor and it is the chosen one for any tumors exceeding 10 cm.…”

Section: Discussionmentioning

confidence: 99%

Primary Adrenal Angiosarcoma and its Management: A Case Report

Alsarraj,

Alqahtani,

Alswayyed

et al. 2023

Cureus

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Primary adrenal angiosarcoma is a very rare malignancy. This is a case report of a 54-year-old female, who presented with right-sided abdominal pain. Magnetic resonance imaging of the abdomen and pelvis showed a right adrenal mass with a maximum dimension of 5.7 cm. The patient went for a laparoscopic right adrenalectomy. The postoperative period was uneventful, and she was discharged on postoperative day 2. The patient was free from complaints at outpatient follow-up visits. Pathology confirmed the diagnosis of adrenal angiosarcoma and the metastasis workup was negative. A multidisciplinary approach through the expertise of medical oncology, surgical oncology, and histopathology is essential for the diagnosis and management of such rare diseases.

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Section: Discussionmentioning

confidence: 99%

Primary Adrenal Angiosarcoma and its Management: A Case Report

Alsarraj,

Alqahtani,

Alswayyed

et al. 2023

Cureus

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“…It was however possible to successfully remove ATs laparoscopically in comparable sized dogs as in the OA group, with the smallest dog treated laparoscopically weighing only 6.5 kg. Across both techniques, duration of right-sided adrenalectomy was significantly longer than for left-sided adrenalectomy, which can be explained by the more complex anatomy of the right adrenal gland including its more hidden location between liver and kidney and its adherence to the vena cava ( 9 , 11 ). The proportion of right-sided LA in our study (49% of unilateral procedures) is relatively high compared to previous reports (29–39% right-sided LA) which might have prolonged mean surgical duration resulting in duration comparable to OA.…”

Section: Discussionmentioning

confidence: 99%

“…The same discrepancy might have been present in the dog with concurrent adrenal- and pituitary-dependent HC, in which histopathology of the suspected hyperplastic adrenal was consistent with ACC. Parameters reported to differentiate ACC from ACA in dogs are somewhat controversial and include peripheral fibrosis, capsular invasion, trabecular growth pattern, hemorrhage, necrosis, single-cell necrosis, hematopoiesis, fibrin thrombi, cytoplasmic vacuolation and increased proliferation index assessed by immunohistochemistry for the Ki67 antigen ( 2 , 11 , 12 , 30 ). More recently, the Utrecht score was shown to be of use in distinguishing dogs with cortisol-secreting ACTs with shorter survival after adrenalectomy ( 29 ).…”

Section: Discussionmentioning

confidence: 99%

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Laparoscopic vs. open adrenalectomy: perioperative data and survival analysis in 70 dogs with an adrenal tumor

van Bokhorst,

Galac,

Kooistra

et al. 2023

Front. Vet. Sci.

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Adrenalectomy is the treatment of choice in case of functional adrenal tumors and malignant adrenal incidentalomas. Laparoscopic adrenalectomy (LA) in dogs has gained popularity in recent years, however, clinical studies on large patient populations are scarce. This retrospective study describes perioperative and recurrence data, survival, and prognostic factors in 70 dogs that underwent LA or open adrenalectomy (OA) in our hospital between 2008 and 2022. Diagnosis was based on history, clinical signs, endocrine function tests and advanced diagnostic imaging. Laparoscopic adrenalectomy was performed in 42 dogs (n = 27 naturally occurring hypercortisolism, n = 4 pheochromocytoma, n = 1 pheochromocytoma with concurrent hypercortisolism, n = 10 incidentaloma) and OA in 28 dogs (n = 22 hypercortisolism, n = 3 pheochromocytoma, n = 3 incidentaloma). Bilateral adrenalectomy was performed in 8/70 dogs. Surgical duration of LA and OA did not differ significantly in unilateral and bilateral procedures (P = 0.108 and P = 0.101, respectively). Systemic hypertension occurred in 7/41 and 1/28 dogs during LA and OA, respectively (P = 0.130). Hypotension occurred in 2/41 and 4/28 dogs during LA and OA, respectively (P = 0.214). A total of 40/42 dogs in the LA group and 27/28 in the OA group survived to discharge (P = 0.810). Mean hospital stay was significantly shorter (P = 0.006) after LA (1.5 days, range 1–3) than after OA (2.2 days, range 1–4). No significant differences were demonstrated between LA and OA groups in recurrence of adrenal-dependent endocrine disease (P = 0.332), disease-free period (P = 0.733) and survival time (P = 0.353). The disease-specific 1-, 2- and 3-year survival rates were 95, 89, and 89% after LA and 92, 88, and 81% after OA. Tumor size was significantly associated with the occurrence of a recurrence. In addition, tumor size had a negative effect on the disease-free period and survival time. This study shows a favorable outcome of both LA and OA in dogs. Based on low perioperative complication rate, short hospitalization time and long-term outcomes comparable to OA in selected cases, the less invasive laparoscopic approach is considered the preferred technique.

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“…Surgical tumor removal remains the primary treatment for malignant adrenal tumors ( 14 ). Adjuvant radiotherapy and chemotherapy may also be administered to patients with advanced or recurrent adrenal tumors ( 12 , 15 ).…”

Section: Introductionmentioning

confidence: 99%

Construction of a novel clinical nomogram to predict cancer-specific survival in patients with primary malignant adrenal tumors: a large population-based retrospective study

Duan

You

et al. 2023

Front. Med.

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BackgroundPrimary malignant adrenal tumors were rare and had a poor prognosis. This investigation aimed to create a useful clinical prediction nomogram to anticipate cancer-specific survival (CSS) of patients with a primary malignant adrenal tumor.MethodThis study included 1748 patients with malignant adrenal tumor diagnoses subjects from 2000 to 2019. These subjects were allocated randomly into training (70%) and validation (30%) cohorts. Patients with adrenal tumors underwent univariate and multivariate Cox regression analyses to identify the CSS-independent predictive biomarkers. Therefore, a nomogram was created depending on those predictors, and calibration curves, receiver operating characteristic (ROC) curves, and decision curve analysis (DCA) were used to assess the calibration capacity of the nomogram, discriminative power, and clinical efficiency, respectively. Afterward, a risk system for categorizing patients with adrenal tumors was established.ResultThe univariate and multivariate Cox analysis demonstrated the CSS-independent predictive factors, including age, tumor stage, size, histological type, and surgery. As a result, a nomogram was developed using these variables. For the 3-, 5-, and 10-year CSS of this nomogram, the values of the area under the curve (AUC) of the ROC curves were 0.829, 0.827, and 0.822, respectively. Furthermore, the AUC values of the nomogram were higher than those of the individual independent prognostic components of CSS, indicating that the nomogram had stronger prognostic prediction reliability. A novel risk stratification method was created to further improve patient stratification and give clinical professionals a better reference for clinical decision-making.ConclusionThrough the developed nomogram and risk stratification method, the CSS of patients with malignant adrenal tumors could be predicted more precisely, assisting physicians to differentiate patients better and creating personalized treatment strategies to optimize patient benefits.

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Update on Adrenalectomy

Cited by 7 publications

References 32 publications

Primary Adrenal Angiosarcoma and its Management: A Case Report

Primary Adrenal Angiosarcoma and its Management: A Case Report

Laparoscopic vs. open adrenalectomy: perioperative data and survival analysis in 70 dogs with an adrenal tumor

Construction of a novel clinical nomogram to predict cancer-specific survival in patients with primary malignant adrenal tumors: a large population-based retrospective study

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