What is the appropriate role of minimally invasive vs. open surgery for small adrenocortical cancers?
Curr Opin Oncol
; 27(1): 44-9, 2015 Jan.
Article
en En
| MEDLINE
| ID: mdl-25390555
ABSTRACT
PURPOSE OF REVIEW The role of endoscopic adrenalectomy for adrenocortical carcinoma is the most controversial and debated points in adrenal surgery. We reviewed the most recent literature on this topic. RECENT FINDINGS:
From the amount of available data (even if not conclusive), the following could be extrapolated first, for patients with apparently localized disease the adrenal gland should be removed en bloc with the entire retroperitoneal fat pad, which also includes some periadrenal lymph nodes, but no extended resection is necessary in absence of involvement of adjacent structures; second, in experienced centers, oncologic outcome for endoscopic adrenalectomy is not inferior to open adrenalectomy when strict selection criteria and the principles of oncologic surgery are respected. When performed by nonexperienced surgeons, endoscopic adrenalectomy may be associated with a higher rate of positive margin and local recurrence; third, patients observed at specialized referral centers receive a more accurate preoperative workup that allows a better operative planning and a more comprehensive postoperative treatment.SUMMARY:
Although waiting for further more exhaustive studies, we think that for suspected adrenocortical carcinoma, smaller than 8-10âcm and without pre or intraoperative evidence of local invasion, endoscopic adrenalectomy in a referral center seems to be an acceptable option.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Neoplasias de la Corteza Suprarrenal
/
Carcinoma Corticosuprarrenal
/
Adrenalectomía
/
Endoscopía
Límite:
Humans
Idioma:
En
Revista:
Curr Opin Oncol
Asunto de la revista:
NEOPLASIAS
Año:
2015
Tipo del documento:
Article
País de afiliación:
Italia