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Does nephrectomy during radical adrenalectomy for stage II adrenocortical cancer affect patient outcome?

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Abstract

Purpose

To evaluate if including nephrectomy in the standard surgical approach to stage II adrenocortical cancer (i.e., adrenalectomy) might modify oncologic outcome of patients.

Methods

We performed a retrospective analysis involving 41 patients with stage II adrenocortical cancer (ACC) who had undergone radical surgery. Patients were divided into two groups according to the surgical procedure: group A = radical adrenalectomy alone, group AN = radical adrenalectomy + radical nephrectomy. Oncologic effectiveness of the procedures was tested comparing the recurrence-free and overall survival of patients of A vs AN groups.

Results

The group A consisted of 25 patients and group AN of 16 patients. No differences were noted between the two groups in terms of demographic data and ACC characteristics. During follow-up, 15/25 (60 %) patients of group A vs 14/16 (87.5 %) patients of group AN experienced a recurrence, after a median of 36 months in group A and 10 months in group AN (p = 0.06); a significant impairment of renal function was recorded in patients of AN group with respect to those of group A. Finally, 13/25 (52 %) patients of group A and 10/16 (62.5 %) patients of group AN died due to ACC-related causes. No differences in survival times were noted (p = 0.3).

Conclusion

Our study suggests that adjunctive nephrectomy does not modify the oncologic results of adrenalectomy in the treatment of stage II ACC in terms of recurrence-free and overall survival. Thus, when there are no signs of ACC local invasion, surgeon should make every effort to preserve the kidney.

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Acknowledgments

The study was performed on behalf of the European Network for the Study of Adrenal Tumors (ENS@T). This study was supported by a Grant of the Piedmont Region (Italy) “Ricerca Sanitaria Finalizzata 2008”.

Author information

Authors and Affiliations

  1. Division of Urology, Department of Oncology, “San Luigi” Hospital-Orbassano, University of Turin, Regione Gonzole 10, 10043, Orbassano, TO, Italy

    F. Porpiglia, C. Fiori & R. M. Scarpa

  2. Division of Internal Medicine, Department of Oncology, “San Luigi” Hospital-Orbassano, University of Turin, Orbassano, TO, Italy

    F. C. Daffara, B. Zaggia, A. Ardito & M. Terzolo

  3. Division of Pathology, Department of Oncology, “San Luigi” Hospital-Orbassano, University of Turin, Orbassano, TO, Italy

    M. Papotti

  4. Medical Oncology Unit, Department of Medical & Surgical Specialties, Radiological Sciences & Public Health, University of Brescia at Spedali Civili Hospital, Brescia, Italy

    A. Berruti

  5. Division of Oncology, Department of Oncology, “San Luigi” Hospital-Orbassano, University of Turin, Orbassano, TO, Italy

    G. V. Scagliotti

Authors
  1. F. Porpiglia
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  2. C. Fiori
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  3. F. C. Daffara
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  4. B. Zaggia
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  5. A. Ardito
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  6. R. M. Scarpa
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  7. M. Papotti
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  8. A. Berruti
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  9. G. V. Scagliotti
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  10. M. Terzolo
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Corresponding author

Correspondence to F. Porpiglia.

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The authors declare that they have no conflict of interest. All authors have no conflict of interest

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Porpiglia, F., Fiori, C., Daffara, F.C. et al. Does nephrectomy during radical adrenalectomy for stage II adrenocortical cancer affect patient outcome?. J Endocrinol Invest 39, 465–471 (2016). https://doi.org/10.1007/s40618-015-0422-4

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  • DOI: https://doi.org/10.1007/s40618-015-0422-4

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