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Langenbeck's Archives of Surgery

, Volume 397, Issue 2, pp 195–199 | Cite as

Adrenocortical carcinoma: which surgical approach?

  • Bruno CarnailleEmail author
Systematic Review and Meta-analysis

Abstract

Introduction

There are no randomised studies comparing open and laparoscopic approaches foradrenalectomy in patients with adrenal cortical carcinoma.

Methods

There is evidence of postoperative benefit for the patients undergoing laparoscopic adrenalectomy compared to open adrenalectomy (level B).

Results

Results from comparison of oncological outcomes in ACC between open and laparoscopic approaches are equivocal: increasedrisk of local recurrence and peritoneal carcinomatosis by the laparoscopic route (level D), and identical results between the two approaches in terms of survival, recurrence and peritoneal carcinomatosis (level C).

Conclusion

An open approach is recommended in case of local invasion, with a view to achieving an R0 resection (level D). Laparoscopic resection of ACC/potentially malignant tumours, which includes removal of surrounding periadrenal fat and results in an R0 resection without tumour capsule rupture, may be performed for preoperative and intraoperative stage 1–2 ACC and tumours with a diameter < 10 cm (level C).

Keywords

Adrenal Cortical carcinoma Surgery Approach Survival 

Notes

Acknowledgments

The author thanks Doctors James Kirkby-Bott and Gianluca Donatini for kind help reviewing this manuscript.

Conflicts of interest

None.

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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  1. 1.Service de Chirurgie EndocrinienneUniversité Lille Nord de FranceLilleFrance

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