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A Novel Method: Super-selective Adrenal Venous Sampling
Published on: September 15, 2017
26.6K
Operative intervention for recurrent adrenocortical cancer
Benzon M Dy1, Kevin B Wise, Melanie L Richards
1Division of Endocrine Surgery, Department of Gastroenterologic and General Surgery, Mayo Clinic, Rochester, MN.
Surgery
|November 19, 2013
Summary
Surgery for recurrent adrenocortical cancer (ACC) improves survival and symptoms. Complete resection and a disease-free interval over six months are key factors for benefiting from this operative intervention.
Area of Science:
- Oncology
- Surgical Oncology
- Adrenocortical Cancer Research
Background:
- Adrenocortical cancer (ACC) frequently recurs even after complete surgical removal.
- The benefits of reoperation for recurrent ACC, in terms of survival and symptom palliation, require further investigation.
Purpose of the Study:
- To evaluate the survival and palliative benefits of surgical resection for patients with recurrent adrenocortical cancer.
- To compare outcomes of operative versus nonoperative management for recurrent ACC.
Main Methods:
- A retrospective review of patients who underwent surgery for ACC between 1980 and 2010.
- Comparison of outcomes between patients treated with resection versus nonoperative management for recurrent disease.
Main Results:
- Patients undergoing operative management for recurrent ACC (65 months) had significantly longer survival than those with nonoperative management (6 months).
- Complete resection (R0) for recurrence and a disease-free interval greater than six months were associated with improved survival.
- Symptomatic improvement was observed in 84% of operative patients compared to 29% of nonoperative patients, with pain and hormone excess being common recurrent symptoms.
Conclusions:
- Surgical intervention for recurrent adrenocortical cancer offers significant survival and symptomatic benefits.
- Complete resection of recurrent ACC, particularly in patients with a disease-free interval >6 months, is associated with favorable outcomes.
- The substantial symptomatic improvement seen with surgery may broaden the indications for operative intervention in recurrent ACC.
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