论文已发表
注册即可获取德孚的最新动态
IF 收录期刊
Authors Zheng G, Li H, Deng J, Zhang X, Wu X
Received 19 November 2017
Accepted for publication 26 January 2018
Published 21 March 2018 Volume 2018:11 Pages 1625—1632
DOI https://doi.org/10.2147/OTT.S157518
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Colin Mak
Peer reviewer comments 3
Editor who approved publication: Dr Ingrid Espinoza
Purpose: Open adrenalectomy (OA) remains the gold standard of surgical
therapy for adrenocortical carcinoma, while the role of laparoscopic approach
is controversial. We aim to explore the influence of surgical approaches on the
oncologic prognosis of adrenocortical carcinoma by comparing the short-term
outcomes of patients undergoing OA with those undergoing laparoscopic
adrenalectomy (LA).
Patients and
methods: We retrospectively analyzed the
baseline characteristics, perioperative data and short-term prognosis of 42
patients diagnosed with stage I–III adrenocortical carcinoma, receiving OA
(n=22) and LA (n=20) as primary therapy. The primary end point was the first
recurrence.
Results: OA group had larger mean maximum diameter of tumor (10.1±3.6
versus 6.3±2.2 cm) and lesser benefits in operative time, bleeding loss and
postoperative hospital stay than laparoscopic group. Mean disease-free survival
(DFS) of OA was 44.8±35.1 months, which was longer than 17.5±10.4 months of LA,
and the rate of 2-year DFS after primary surgery in the open group was higher
than in the laparoscopic group (61.1% versus 21.4%, respectively). Rates of 1-
and 3-year DFS showed no significant difference. All patients undergoing LA
(11/11) showed local recurrent lesions at the first time of recurrence, while 5
of 13 patients undergoing OA did not show local recurrence (P =0.03).
Conclusion: OA for adrenocortical carcinoma is superior to laparoscopic
approach in terms of DFS and rate of 2-year DFS, in spite of the larger maximum
diameter of tumors and lesser benefit during perioperation. After LA, patients
are more likely to show local recurrent lesions at the first time of relapse.
Keywords: adrenocortical carcinoma, adrenalectomy, open surgery,
laparoscopy, prognosis