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Porpiglia F, Fiori C, Daffara FC, Zaggia B, Ardito A, Scarpa RM, Papotti M, Berruti A, Scagliotti GV, Terzolo M. Does nephrectomy during radical adrenalectomy for stage II adrenocortical cancer affect patient outcome? J Endocrinol Invest 2016; 39:465-71. [PMID: 26694705 DOI: 10.1007/s40618-015-0422-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Accepted: 12/07/2015] [Indexed: 10/22/2022]
Abstract
PURPOSE To evaluate if including nephrectomy in the standard surgical approach to stage II adrenocortical cancer (i.e., adrenalectomy) might modify oncologic outcome of patients. METHODS We performed a retrospective analysis involving 41 patients with stage II adrenocortical cancer (ACC) who had undergone radical surgery. Patients were divided into two groups according to the surgical procedure: group A = radical adrenalectomy alone, group AN = radical adrenalectomy + radical nephrectomy. Oncologic effectiveness of the procedures was tested comparing the recurrence-free and overall survival of patients of A vs AN groups. RESULTS The group A consisted of 25 patients and group AN of 16 patients. No differences were noted between the two groups in terms of demographic data and ACC characteristics. During follow-up, 15/25 (60 %) patients of group A vs 14/16 (87.5 %) patients of group AN experienced a recurrence, after a median of 36 months in group A and 10 months in group AN (p = 0.06); a significant impairment of renal function was recorded in patients of AN group with respect to those of group A. Finally, 13/25 (52 %) patients of group A and 10/16 (62.5 %) patients of group AN died due to ACC-related causes. No differences in survival times were noted (p = 0.3). CONCLUSION Our study suggests that adjunctive nephrectomy does not modify the oncologic results of adrenalectomy in the treatment of stage II ACC in terms of recurrence-free and overall survival. Thus, when there are no signs of ACC local invasion, surgeon should make every effort to preserve the kidney.
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Affiliation(s)
- F Porpiglia
- Division of Urology, Department of Oncology, "San Luigi" Hospital-Orbassano, University of Turin, Regione Gonzole 10, 10043, Orbassano, TO, Italy.
| | - C Fiori
- Division of Urology, Department of Oncology, "San Luigi" Hospital-Orbassano, University of Turin, Regione Gonzole 10, 10043, Orbassano, TO, Italy
| | - F C Daffara
- Division of Internal Medicine, Department of Oncology, "San Luigi" Hospital-Orbassano, University of Turin, Orbassano, TO, Italy
| | - B Zaggia
- Division of Internal Medicine, Department of Oncology, "San Luigi" Hospital-Orbassano, University of Turin, Orbassano, TO, Italy
| | - A Ardito
- Division of Internal Medicine, Department of Oncology, "San Luigi" Hospital-Orbassano, University of Turin, Orbassano, TO, Italy
| | - R M Scarpa
- Division of Urology, Department of Oncology, "San Luigi" Hospital-Orbassano, University of Turin, Regione Gonzole 10, 10043, Orbassano, TO, Italy
| | - M Papotti
- Division of Pathology, Department of Oncology, "San Luigi" Hospital-Orbassano, University of Turin, Orbassano, TO, Italy
| | - A Berruti
- Medical Oncology Unit, Department of Medical & Surgical Specialties, Radiological Sciences & Public Health, University of Brescia at Spedali Civili Hospital, Brescia, Italy
| | - G V Scagliotti
- Division of Oncology, Department of Oncology, "San Luigi" Hospital-Orbassano, University of Turin, Orbassano, TO, Italy
| | - M Terzolo
- Division of Internal Medicine, Department of Oncology, "San Luigi" Hospital-Orbassano, University of Turin, Orbassano, TO, Italy
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