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2020-09-01

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cc-by-nc-nd (c) AME Publishing Company, 2020
Si us plau utilitzeu sempre aquest identificador per citar o enllaçar aquest document: https://hdl.handle.net/2445/173321

Laparoscopy versus open adrenalectomy in patients with solid tumor metastases: results of a multicenter European study

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https://doi.org/10.21037/gs.2019.10.15

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Background: The outcome of adrenalectomy carried out by laparoscopy or open surgery for solid tumor metastases was assessed. Methods: A total of 317 patients with histologically confirmed adrenal metastatic disease collected from 30 centres in Europe underwent adrenalectomy by laparoscopy (n=146) or open laparotomy (n=171). Differences between laparoscopic and open adrenalectomy were assessed by a single Cox analysis for both procedures. Results: The median overall survival was 24.0 [95% confidence interval (CI): 21.4-26.6] months for open adrenalectomy and 45.0 (95% CI: 22.6-67.4) for laparoscopic adrenalectomy (P=0.008). Survival rates were 68%, 49%, 35% and 29% at 1, 2, 3 and 5 years for open surgery vs. 88%, 62%, 52% and 46% for laparoscopy, respectively. In the subgroup of R0 resections, the difference in survival in favor of laparoscopy (median 46 vs. 27 months) was marginally significant (P=0.073). Renal cancer [hazard ratio (HR) 0.42; 95% CI: 0.23-0.76, P=0.005], surgery of the primary tumor (HR 0.33; 95% CI: 0.19-0.54), and use of chemotherapy (HR 0.62; 95% CI: 0.43-0.88) were associated with a better survival, whereas type of resection (R1/R2 vs. R0) was associated with a worse prognosis (HR 2.29; 95% CI: 1.52-3.44, P<0.001). Conclusions: Laparoscopic adrenalectomy patients showed a longer survival than open adrenalectomy individuals, as minimally invasive approach was attempted more common in less advanced disease which led to higher number of R0 resections.

Matèries

Laparoscòpia, Metàstasi, Tumors

Matèries (anglès)

Laparoscopy, Metastasis, Tumors

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Articles publicats en revistes (Ciències Clíniques)
Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer)
Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))

Citació

MORENO LLORENTE, Pablo, QUINTANA BASARRATE, Aitor de la, MUSHOLT, Thomas j., PAUNOVIC, Ivan, PUCCINI, Marco, VIDAL PÉREZ, Oscar, ORTEGA, Joaquín, KRAIMPS, Jean-louis, European Study Group for Metastatic Adrenalectomy. Laparoscopy versus open adrenalectomy in patients with solid tumor metastases: results of a multicenter European study. _Gland Surgery_. 2020. Vol. 9, núm. 2, pàgs. 159-165. [consulta: 24 de gener de 2026]. ISSN: 2227-684X. [Disponible a: https://hdl.handle.net/2445/173321]

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