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Adrenocortical carcinoma: which surgical approach?

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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).

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Acknowledgments

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

Conflicts of interest

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Authors and Affiliations

  1. Service de Chirurgie Endocrinienne, Université Lille Nord de France, CHU, 59037, Lille, Cedex, France

    Bruno Carnaille

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  1. Bruno Carnaille
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Correspondence to Bruno Carnaille.

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Carnaille, B. Adrenocortical carcinoma: which surgical approach?. Langenbecks Arch Surg 397, 195–199 (2012). https://doi.org/10.1007/s00423-011-0852-1

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  • DOI: https://doi.org/10.1007/s00423-011-0852-1

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