Pablo Moreno1, Aitor de la Quintana Basarrate2, Thomas J Musholt3, Ivan Paunovic4, Marco Puccini5, Óscar Vidal6, Joaquín Ortega7, Jean-Louis Kraimps8. 1. Unidad de Cirugía Endocrina, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain. 2. Unidad de Cirugía Endocrina, Servicio de Cirugía General, Hospital de Cruces, Barakaldo, Bizkaia, Spain. 3. Endocrine Surgery Section, Department of General, Visceral-, and Transplantation, University Medical Center of the Johannes Gutenberg University, Mainz, Germany. 4. Center for Endocrine Surgery, Clinical Centre of Serbia Medical School, University of Belgrade, Belgrade, Serbia. 5. Department of General Surgery, Cisanello Hospital, University of Pisa, Pisa, Italy. 6. Department of General & Endocrine Surgery, ICMDiM, Hospital Clinic-IDIBAPS, University of Barcelona, Barcelona, Spain. 7. Department of Surgery, Hospital Clínico Universitario, University of Valencia, Valencia, Spain. 8. Department of Endocrine Surgery, Jean Bernard Hospital, Poitiers University, Poitiers, France.
Abstract
BACKGROUND: The outcome of adrenalectomy carried out by laparoscopy or open surgery for solid tumor metastases was assessed. METHODS: A total of 317 patients with histologically confirmed adrenal metastatic disease collected from 30 centres in Europe underwent adrenalectomy by laparoscopy (n=146) or open laparotomy (n=171). Differences between laparoscopic and open adrenalectomy were assessed by a single Cox analysis for both procedures. RESULTS: The median overall survival was 24.0 [95% confidence interval (CI): 21.4-26.6] months for open adrenalectomy and 45.0 (95% CI: 22.6-67.4) for laparoscopic adrenalectomy (P=0.008). Survival rates were 68%, 49%, 35% and 29% at 1, 2, 3 and 5 years for open surgery vs. 88%, 62%, 52% and 46% for laparoscopy, respectively. In the subgroup of R0 resections, the difference in survival in favor of laparoscopy (median 46 vs. 27 months) was marginally significant (P=0.073). Renal cancer [hazard ratio (HR) 0.42; 95% CI: 0.23-0.76, P=0.005], surgery of the primary tumor (HR 0.33; 95% CI: 0.19-0.54), and use of chemotherapy (HR 0.62; 95% CI: 0.43-0.88) were associated with a better survival, whereas type of resection (R1/R2 vs. R0) was associated with a worse prognosis (HR 2.29; 95% CI: 1.52-3.44, P<0.001). CONCLUSIONS: Laparoscopic adrenalectomy patients showed a longer survival than open adrenalectomy individuals, as minimally invasive approach was attempted more common in less advanced disease which led to higher number of R0 resections. 2020 Gland Surgery. All rights reserved.
BACKGROUND: The outcome of adrenalectomy carried out by laparoscopy or open surgery for solid tumor metastases was assessed. METHODS: A total of 317 patients with histologically confirmed adrenal metastatic disease collected from 30 centres in Europe underwent adrenalectomy by laparoscopy (n=146) or open laparotomy (n=171). Differences between laparoscopic and open adrenalectomy were assessed by a single Cox analysis for both procedures. RESULTS: The median overall survival was 24.0 [95% confidence interval (CI): 21.4-26.6] months for open adrenalectomy and 45.0 (95% CI: 22.6-67.4) for laparoscopic adrenalectomy (P=0.008). Survival rates were 68%, 49%, 35% and 29% at 1, 2, 3 and 5 years for open surgery vs. 88%, 62%, 52% and 46% for laparoscopy, respectively. In the subgroup of R0 resections, the difference in survival in favor of laparoscopy (median 46 vs. 27 months) was marginally significant (P=0.073). Renal cancer [hazard ratio (HR) 0.42; 95% CI: 0.23-0.76, P=0.005], surgery of the primary tumor (HR 0.33; 95% CI: 0.19-0.54), and use of chemotherapy (HR 0.62; 95% CI: 0.43-0.88) were associated with a better survival, whereas type of resection (R1/R2 vs. R0) was associated with a worse prognosis (HR 2.29; 95% CI: 1.52-3.44, P<0.001). CONCLUSIONS: Laparoscopic adrenalectomy patients showed a longer survival than open adrenalectomy individuals, as minimally invasive approach was attempted more common in less advanced disease which led to higher number of R0 resections. 2020 Gland Surgery. All rights reserved.
Entities:
Keywords:
Adrenalectomy; laparoscopic adrenalectomy; open adrenalectomy; retrospective study; survival
Authors: Hendrik J Plaggemars; Eduardo M Targarona; Gijs van Couwelaar; Michele D Ambra; Anna García; Pere Rebasa; Xavier Rius; Manuel Trias Journal: Cir Esp Date: 2005-03 Impact factor: 1.653
Authors: Bianca J Vazquez; Melanie L Richards; Christine M Lohse; Geoffrey B Thompson; David R Farley; Clive S Grant; Marianne Huebner; Jose Moreno Journal: World J Surg Date: 2012-06 Impact factor: 3.352
Authors: Pablo Moreno; Aitor de la Quintana Basarrate; Thomas J Musholt; Ivan Paunovic; Marco Puccini; Oscar Vidal; Joaquín Ortega; Jean-Louis Kraimps; Elisabet Bollo Arocena; José M Rodríguez; Oscar González López; Carlos D Del Pozo; Maurizio Iacobone; Enrique Veloso; José M Del Pino; Iñigo García Sanz; David Scott-Coombes; Jesús Villar-Del-Moral; José I Rodríguez; Jaime Vázquez Echarri; Carmen González Sánchez; María-Teresa Gutiérrez Rodríguez; Ignacio Escoresca; José Nuño Vázquez-Garza; Ernesto Tobalina Aguirrezábal; Jesús Martín; Mari Fe Candel Arenas; Kerstin Lorenz; Juan M Martos; José M Ramia Journal: Surgery Date: 2013-12 Impact factor: 3.982
Authors: Vivian E Strong; Michael D'Angelica; Laura Tang; Francesco Prete; Mithat Gönen; Daniel Coit; Karim A Touijer; Yuman Fong; Murray F Brennan Journal: Ann Surg Oncol Date: 2007-07-31 Impact factor: 5.344
Authors: F J Collinson; T K Lam; W M J Bruijn; J H W de Wilt; M Lamont; J F Thompson; R F Kefford Journal: Ann Surg Oncol Date: 2008-04-01 Impact factor: 5.344
Authors: Elizabeth Vlk; Andreas Ebbehoj; Frede Donskov; Per Løgstrup Poulsen; Badal Sheiko Rashu; Lasse Bro; Mikael Aagaard; Lars Rolighed Journal: BJS Open Date: 2022-03-08