Prevalence and Prognostic Value of Lymph Node Dissection in Treating Adrenocortical Carcinoma: A National Experience
Shaheen Alanee1, Danuta Dynda2, Bradley Holland2
1Division of Urology, Department of Surgery, Southern Illinois University School of Medicine, Springfield, IL, U.S.A. salanee@siumed.edu.
Aim:
We examined a national database to investigate the role of lymph node dissection (LND) in adrenocortical carcinoma (ACC) treated surgically.
Patients And Methods:
Patient data diagnosed with ACC between 1991 and 2011 were extracted from a national database. Predictors of LND, positive lymph nodes on LND, and the association between positive LND and cancer-specific death were examined.
Results:
Only 5.39% of patients underwent LND, and 31.03% had positive lymph nodes. Disease stage was the only significant predictor of LND (odds ratio=3.061; 95% confidence interval=1.158-8.091), and finding more than one positive lymph nodes on LND was the only significant predictor of cancer-specific death (hazard ratio=3.13; 95% confidence interval=1.233-7.95) in tumors larger than 3 cm in size.
Conclusion:
LND is not a common practice in treating ACC in the United States. The finding of more than one positive lymph nodes on LND for ACC is associated with poor prognosis.
