Adrenocortical carcinoma: is the surgical approach a risk factor of peritoneal carcinomatosis?

Détails

ID Serval
serval:BIB_79D7992AD7F2
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Adrenocortical carcinoma: is the surgical approach a risk factor of peritoneal carcinomatosis?
Périodique
Eur J Endocrinol
Auteur(s)
Leboulleux S., Deandreis D., Al Ghuzlan A., Auperin A., Goere D., Dromain C., Elias D., Caillou B., Travagli J. P., De Baere T., Lumbroso J., Young J., Schlumberger M., Baudin E.
ISSN-L
1479-683X (Electronic)0804-4643 (Linking)
Statut éditorial
Publié
Date de publication
2010
Peer-reviewed
Oui
Volume
162
Numéro
6
Pages
1147-53
Langue
anglais
Notes
Leboulleux, SDeandreis, DAl Ghuzlan, AAuperin, AGoere, DDromain, CElias, DCaillou, BTravagli, J PDe Baere, TLumbroso, JYoung, JSchlumberger, MBaudin, EengEngland2010/03/30 06:00Eur J Endocrinol. 2010 Jun;162(6):1147-53. doi: 10.1530/EJE-09-1096. Epub 2010 Mar 26.
Résumé
CONTEXT: Peritoneal carcinomatosis (PC) is a rare site of distant metastases in patients with adrenocortical cancer (ACC). One preliminary study suggests an increased risk of PC after laparoscopic adrenalectomy (LA) for ACC. OBJECTIVE: The objective of the study was to search for risk factors of PC including surgical approach. DESIGN: This was a retrospective cohort study conducted in an institutional practice. PATIENTS: Sixty-four consecutive patients with ACC seen at our institution between 2003 and 2009 were included. Mean tumor size was 132 mm. Patients had stage I disease in 2 cases, stage II disease in 32 cases, stage III disease in 7 cases, stage IV disease in 21 cases, and unknown stage disease in 2 cases. Surgery was open in 58 cases and laparoscopic in 6 cases. MAIN OUTCOME: The main outcome was the risk factors of PC. RESULTS: PC occurred in 18 (28%) patients. It was present at initial diagnosis in three cases and occurred during follow-up in 15 cases. The only risk factor of PC occurring during follow-up was the surgical approach with a 4-year rate of PC of 67% (95% confidence interval (CI), 30-90%) for LA and 27% (95% CI, 15-44%) for open adrenalectomy (P=0.016). Neither tumor size, stage, functional status, completeness of surgery, nor plasma level of op'DDD was associated with the occurrence of PC. CONCLUSION: We found an increased risk of PC after LA for ACC. Whether this is related to an inappropriate surgical approach or to insufficient experience in ACC surgery should be clarified by a prospective program.
Mots-clé
Adrenal Cortex Neoplasms/pathology/*surgery, Adrenalectomy/*adverse effects, Adrenocortical Carcinoma/secondary/*surgery, Adult, Aged, Female, Humans, Laparoscopy/*adverse effects, Male, Middle Aged, Neoplasm Staging, Patient Selection, Peritoneal Neoplasms/*etiology/*secondary, Retrospective Studies, Treatment Outcome
Open Access
Oui
Création de la notice
16/09/2016 11:13
Dernière modification de la notice
08/05/2019 20:44
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