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Horm Metab Res 2013; 45(02): 130-136
DOI: 10.1055/s-0032-1331743
Review
© Georg Thieme Verlag KG Stuttgart · New York

Is There a Role for Laparoscopic Adrenalectomy in Patients with Suspected Adrenocortical Carcinoma? A Critical Appraisal of the Literature

C. Jurowich
1   Department of General, Visceral, Vascular and Pediatric Surgery, University Hospital, University of Würzburg, Würzburg, Germany
,
M. Fassnacht
2   Endocrine Unit, Department of Internal Medicine I, University Hospital, University of Würzburg, Würzburg, Germany
3   Department of Internal Medicine IV, Klinikum der Universität München, Munich, Germany
,
M. Kroiss
2   Endocrine Unit, Department of Internal Medicine I, University Hospital, University of Würzburg, Würzburg, Germany
,
T. Deutschbein
2   Endocrine Unit, Department of Internal Medicine I, University Hospital, University of Würzburg, Würzburg, Germany
,
C.-T. Germer
1   Department of General, Visceral, Vascular and Pediatric Surgery, University Hospital, University of Würzburg, Würzburg, Germany
,
J. Reibetanz
1   Department of General, Visceral, Vascular and Pediatric Surgery, University Hospital, University of Würzburg, Würzburg, Germany
› Author Affiliations
Further Information

Publication History

received 31 July 2012

accepted 30 November 2012

Publication Date:
11 January 2013 (online)

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Is There a Role for Laparoscopic Adrenalectomy in Patients with Suspected Adrenocortical Carcinoma? A Critical Appraisal of the LiteratureHorm Metab Res 2013; 45(02): e1-e1
DOI: 10.1055/s-0033-1337919

Abstract

Adrenocortical carcinoma (ACC) is a rare endocrine neoplasm and complete resection is the only treatment with curative intent for patients with nonmetastatic disease. It is highly debatable whether minimally invasive surgery is oncologically equal to open procedures in these patients. This review summarizes the current knowledge on the feasibility and oncological effectiveness of laparoscopic surgery for ACC. Using a Pubmed search strategy covering the time period up until July 2012, we identified 568 original articles and reviews with the following search terms: “adrenal gland neoplasms” and “laparoscopy“, with restriction to patients over 18 years of age. Finally, 23 publications, including 6 “key studies”, became the basis of this review. The key papers described 673 patients with localized ACC, of whom 112 had laparoscopic surgery. Acknowledging the subjectivity of our personal view, we draw the following conclusions: 1) since all available studies are retrospective, a final judgment of laparoscopic surgery in ACC cannot be provided; 2) the surgical treatment of patients with (suspected) ACC should be limited to specialized centers; and 3) For tumors of limited size (<10 cm) without evidence of invasiveness, laparoscopic adrenalectomy does not seem to be oncologically inferior to open surgery when performed in a state of the art manner and when oncological standards (margin-free resection, avoidance of tumor spillage) are respected. However, open adrenalectomy should still be regarded as standard treatment for ACC and laparoscopic surgery should be performed within a clinical trial or at least as an observational study.

Key words

adrenocortical carcinoma - laparoscopic surgery - oncology
 

  • References

  • 1 Fassnacht M, Libe R, Kroiss M, Allolio B. Adrenocortical Carcinoma: a clinician’s update. Nat Rev Endocrinol 2011; 7: 323-335
    CrossrefPubMedGoogle Scholar
  • 2 Libe R, Fratticci A, Bertherat J. Adrenocortical cancer: pathophysiology and clinical management. Endocr Relat Cancer 2007; 14: 13-28
    CrossrefPubMedGoogle Scholar
  • 3 Lacroix A. Approach to the patient with adrenocortical carcinoma. J Clin Endocrinol Metab 2010; 95: 4812-4822
    CrossrefPubMedGoogle Scholar
  • 4 Fassnacht M, Johanssen S, Fenske W, Weismann D, Agha A, Beuschlein F, Fuhrer D, Jurowich C, Quinkler M, Petersenn S, Spahn M, Hahner S, Allolio B. Improved survival in patients with stage II adrenocortical carcinoma followed up prospectively by specialized centers. J Clin Endocrinol Metab 2010; 95: 4925-4932
    CrossrefPubMedGoogle Scholar
  • 5 Gagner M, Lacroix A, Bolte E. Laparoscopic adrenalectomy in Cushing’s syndrome and pheochromocytoma. N Engl J Med 1992; 327: 1033
    CrossrefPubMedGoogle Scholar
  • 6 Assalia A, Gagner M. Laparoscopic adrenalectomy. Br J Surg 2004; 91: 1259-1274
    CrossrefPubMedGoogle Scholar
  • 7 Brix D, Allolio B, Fenske W, Agha A, Dralle H, Jurowich C, Langer P, Mussack T, Nies C, Riedmiller H, Spahn M, Weismann D, Hahner S, Fassnacht M. Laparoscopic versus open adrenalectomy for adrenocortical carcinoma: surgical and oncologic outcome in 152 patients. Eur Urol 2010; 58: 609-615
    CrossrefPubMedGoogle Scholar
  • 8 Porpiglia F, Fiori C, Daffara F, Zaggia B, Bollito E, Volante M, Berruti A, Terzolo M. Retrospective Evaluation of the Outcome of Open Versus Laparoscopic Adrenalectomy for Stage I and II Adrenocortical Cancer. Eur Urol 2010; 57: 873-878
    CrossrefPubMedGoogle Scholar
  • 9 Eto M, Hamaguchi M, Harano M, Yokomizo A, Tatsugami K, Naito S. Laparoscopic adrenalectomy for malignant tumors. Int J Urol 2008; 15: 295-298
    CrossrefPubMedGoogle Scholar
  • 10 Haleblian GE, Wilson C, Haddad D, Albala DM. Adrenocortical carcinoma: role of laparoscopic surgery in treatment. Expert Rev Anticancer Ther 2007; 7: 1295-1300
    CrossrefPubMedGoogle Scholar
  • 11 Porpiglia F, Miller BS, Manfredi M, Fiori C, Doherty GM. A debate on laparoscopic versus open adrenalectomy for adrenocortical carcinoma. Horm Cancer 2011; 2: 372-377
    CrossrefPubMedGoogle Scholar
  • 12 Fassnacht M, Terzolo M, Allolio B, Baudin E, Haak H, Berruti A, Welin S, Schade-Brittinger C, Lacroix A, Jarzab B, Sorbye H, Torpy DJ, Stepan V, Schteingart DE, Arlt W, Kroiss M, Leboulleux S, Sperone P, Sundin A, Hermsen I, Hahner S, Willenberg HS, Tabarin A, Quinkler M, de la Fouchardiere C, Schlumberger M, Mantero F, Weismann D, Beuschlein F, Gelderblom H, Wilmink H, Sender M, Edgerly M, Kenn W, Fojo T, Muller HH, Skogseid B. Combination chemotherapy in advanced adrenocortical carcinoma. N Engl J Med 2012; 366: 2189-2197
    CrossrefPubMedGoogle Scholar
  • 13 Fassnacht M, Hahner S, Polat B, Koschker AC, Kenn W, Flentje M, Allolio B. Adjuvant radiation therapy of the tumor bed prevents local recurrences in adrenocortical carcinoma. Exp Clin Endocrinol Diabet 2006; 114 (Suppl. 01) S17 (abstract P01-003)
    PubMedGoogle Scholar
  • 14 Terzolo M, Angeli A, Fassnacht M, Daffara F, Tauchmanova L, Conton PA, Rossetto R, Buci L, Sperone P, Grossrubatscher E, Reimondo G, Bollito E, Papotti M, Saeger W, Hahner S, Koschker AC, Arvat E, Ambrosi B, Loli P, Lombardi G, Mannelli M, Bruzzi P, Mantero F, Allolio B, Dogliotti L, Berruti A. Adjuvant mitotane treatment for adrenocortical carcinoma. N Engl J Med 2007; 356: 2372-2380
    CrossrefPubMedGoogle Scholar
  • 15 Sabolch A, Feng M, Griffith K, Hammer G, Doherty G, Ben-Josef E. Adjuvant and Definitive Radiotherapy for Adrenocortical Carcinoma. Int J Radiat Oncol Biol Phys 2010; 80: 1477-1484
    PubMedGoogle Scholar
  • 16 Datrice NM, Langan RC, Ripley RT, Kemp CD, Steinberg SM, Wood BJ, Libutti SK, Fojo T, Schrump DS, Avital I. Operative management for recurrent and metastatic adrenocortical carcinoma. J Surg Oncol 2012; 105: 709-713
    CrossrefPubMedGoogle Scholar
  • 17 Erdogan I, Deutschbein T, Jurowich C, Kroiss M, Maaa Q, Jaaa W, Willenberg HS, Beuschlein F, Fottner C, Brix D, Fenske W, Reibetanz J, Allolio B, Fassnacht M. on behalf of the German Adrenocortical Carcinoma Study Group . The role of surgery in the management of recurrent adrenocortical carcinoma. J Clin Endocrinol Metab 2012; Nov 12 DOI: 10.1210/jc.2012-2559. [Epub ahead of print]
    PubMedGoogle Scholar
  • 18 Gonzalez RJ, Shapiro S, Sarlis N, Vassilopoulou-Sellin R, Perrier ND, Evans DB, Lee JE. Laparoscopic resection of adrenal cortical carcinoma: a cautionary note. Surgery 2005; 138: 1078-1085 discussion 1085–1076
    CrossrefPubMedGoogle Scholar
  • 19 Leboulleux S, Deandreis D, Al Ghuzlan A, Auperin A, Goere D, Dromain C, Elias D, Caillou B, Travagli JP, De Baere T, Lumbroso J, Young J, Schlumberger M, Baudin E. Adrenocortical carcinoma: is the surgical approach a risk factor of peritoneal carcinomatosis?. Eur J Endocrinol 2010; 162: 1147-1153
    CrossrefPubMedGoogle Scholar
  • 20 Miller BS, Ammori JB, Gauger PG, Broome JT, Hammer GD, Doherty GM. Laparoscopic resection is inappropriate in patients with known or suspected adrenocortical carcinoma. World J Surg 2010; 34: 1380-1385
    CrossrefPubMedGoogle Scholar
  • 21 Lombardi CP, Raffaelli M, De Crea C, Boniardi M, De Toma G, Marzano LA, Miccoli P, Minni F, Morino M, Pelizzo MR, Pietrabissa A, Renda A, Valeri A, Bellantone R. Open versus endoscopic adrenalectomy in the treatment of localized (stage I/II) adrenocortical carcinoma: Results of a multiinstitutional Italian survey. Surgery 2012; 152: 1158-1164
    CrossrefPubMedGoogle Scholar
  • 22 Bellantone R, Ferrante A, Raffaelli M, Boscherini M, Lombardi CP, Crucitti F. Adrenal cystic lesions: report of 12 surgically treated cases and review of the literature. J Endocrinol Invest 1998; 21: 109-114
    CrossrefPubMedGoogle Scholar
  • 23 Reibetanz J, Jurowich C, Erdogan I, Nies C, Rayes N, Dralle H, Behrend M, Allolio B, Fassnacht M, German ACCsg. Impact of lymphadenectomy on the oncologic outcome of patients with adrenocortical carcinoma. Ann Surg 2012; 255: 363-369
    CrossrefPubMedGoogle Scholar
  • 24 Simmons MN, Kaouk J, Gill IS, Fergany A. Laparoscopic radical nephrectomy with hilar lymph node dissection in patients with advanced renal cell carcinoma. Urology 2007; 70: 43-46
    PubMedGoogle Scholar
  • 25 Bilimoria KY, Shen WT, Elaraj D, Bentrem DJ, Winchester DJ, Kebebew E, Sturgeon C. Adrenocortical carcinoma in the United States: treatment utilization and prognostic factors. Cancer 2008; 113: 3130-3136
    CrossrefPubMedGoogle Scholar
  • 26 Jayne DG, Thorpe HC, Copeland J, Quirke P, Brown JM, Guillou PJ. Five-year follow-up of the Medical Research Council CLASICC trial of laparoscopically assisted versus open surgery for colorectal cancer. Br J Surg 2010; 97: 1638-1645
    CrossrefPubMedGoogle Scholar
  • 27 Gaur DD. Laparoscopic operative retroperitoneoscopy: use of a new device. J Urol 1992; 148: 1137-1139
    CrossrefPubMedGoogle Scholar
  • 28 Walz MK, Alesina PF, Wenger FA, Deligiannis A, Szuczik E, Petersenn S, Ommer A, Groeben H, Peitgen K, Janssen OE, Philipp T, Neumann HP, Schmid KW, Mann K. Posterior retroperitoneoscopic adrenalectomy – results of 560 procedures in 520 patients. Surgery 2006; 140: 943-948 discussion 948–950
    CrossrefPubMedGoogle Scholar
  • 29 Constantinides VA, Christakis I, Touska P, Palazzo FF. Systematic review and meta-analysis of retroperitoneoscopic versus laparoscopic adrenalectomy. Br J Surg 2012; 99: 1639-1648
    CrossrefPubMedGoogle Scholar
  • 30 Porpiglia F, Fiori C, Daffara F, Zaggia B, Bollito E, Volante M, Berruti A, Terzolo M. Retrospective evaluation of the outcome of open versus laparoscopic adrenalectomy for stage I and II adrenocortical cancer. Eur Urol 2010; 57: 873-878
    CrossrefPubMedGoogle Scholar
  • 31 Greco F, Hoda MR, Rassweiler J, Fahlenkamp D, Neisius DA, Kutta A, Thuroff JW, Krause A, Strohmaier WL, Bachmann A, Hertle L, Popken G, Deger S, Doehn C, Jocham D, Loch T, Lahme S, Janitzky V, Gilfrich CP, Klotz T, Kopper B, Rebmann U, Kalbe T, Wetterauer U, Leitenberger A, Rassler J, Kawan F, Inferrera A, Wagner S, Fornara P. Laparoscopic adrenalectomy in urological centres – the experience of the German Laparoscopic Working Group. BJU Int 2011; 108: 1646-1651
    CrossrefPubMedGoogle Scholar
  • 32 Lombardi CP, Raffaelli M, Boniardi M, De Toma G, Marzano LA, Miccoli P, Minni F, Morino M, Pelizzo MR, Pietrabissa A, Renda A, Valeri A, De Crea C, Bellantone R. Adrenocortical carcinoma: effect of hospital volume on patient outcome. Langenbecks Arch Surg 2012; 397: 201-207
    CrossrefPubMedGoogle Scholar
  • 33 Hermsen IG, Kerkhofs TM, Butter G, Kievit J, van Eijck CH, Nieveen van Dijkum EJ, Haak HR. Surgery in adrenocortical carcinoma: Importance of national cooperation and centralized surgery. Surgery 2012; 152: 50-56
    CrossrefPubMedGoogle Scholar
  • 34 Hobart MG, Gill IS, Schweizer D, Sung GT, Bravo EL. Laparoscopic adrenalectomy for large-volume (> or=5 cm) adrenal masses. J Endourol 2000; 14: 149-154
    CrossrefPubMedGoogle Scholar
  • 35 Henry JF, Sebag F, Iacobone M, Mirallie E. Results of laparoscopic adrenalectomy for large and potentially malignant tumors. World J Surg 2002; 26: 1043-1047
    CrossrefPubMedGoogle Scholar
  • 36 Kebebew E, Siperstein AE, Clark OH, Duh QY. Results of laparoscopic adrenalectomy for suspected and unsuspected malignant adrenal neoplasms. Arch Surg 2002; 137: 948-951 discussion 952–943
    CrossrefPubMedGoogle Scholar
  • 37 Castilho LN, Mitre AI, Arap S. Laparoscopic adrenal surgery in a Brazilian center. J Endourol 2003; 17: 11-18
    CrossrefPubMedGoogle Scholar
  • 38 Moinzadeh A, Gill IS. Laparoscopic radical adrenalectomy for malignancy in 31 patients. J Urol 2005; 173: 519-525
    CrossrefPubMedGoogle Scholar
  • 39 Palazzo FF, Sebag F, Sierra M, Ippolito G, Souteyrand P, Henry JF. Long-term outcome following laparoscopic adrenalectomy for large solid adrenal cortex tumors. World J Surg 2006; 30: 893-898
    CrossrefPubMedGoogle Scholar
  • 40 Lombardi CP, Raffaelli M, De Crea C, Bellantone R. Role of laparoscopy in the management of adrenal malignancies. J Surg Oncol 2006; 94: 128-131
    CrossrefPubMedGoogle Scholar
  • 41 Lodin M, Privitera A, Giannone G. Laparoscopic adrenalectomy (LA): keys to success: correct surgical indications, adequate preoperative preparation, surgical team experience. Surg Laparosc Endosc Percutan Tech 2007; 17: 392-395
    CrossrefPubMedGoogle Scholar
  • 42 Nocca D, Aggarwal R, Mathieu A, Blanc PM, Deneve E, Salsano V, Figueira G, Sanders G, Domergue J, Millat B, Fabre PR. Laparoscopic surgery and corticoadrenalomas. Surg Endosc 2007; 21: 1373-1376
    CrossrefPubMedGoogle Scholar
  • 43 Hemal AK, Singh A, Gupta NP. Whether adrenal mass more than 5 cm can pose problem in laparoscopic adrenalectomy? An evaluation of 22 patients. World J Urol 2008; 26: 505-508
    CrossrefPubMedGoogle Scholar
  • 44 Liao CH, Chueh SC, Lai MK, Hsiao PJ, Chen J. Laparoscopic adrenalectomy for potentially malignant adrenal tumors greater than 5 centimeters. J Clin Endocrinol Metab 2006; 91: 3080-3083
    CrossrefPubMedGoogle Scholar
  • 45 Parnaby CN, Chong PS, Chisholm L, Farrow J, Connell JM, O’Dwyer PJ. The role of laparoscopic adrenalectomy for adrenal tumours of 6 cm or greater. Surg Endosc 2008; 22: 617-621
    CrossrefPubMedGoogle Scholar
  • 46 Mellon MJ, Sundaram CP. Laparoscopic adrenalectomy for pheochromocytoma versus other surgical indications. JSLS 2008; 12: 380-384
    PubMedGoogle Scholar
  • 47 Conzo G, Tricarico A, Belli G, Candela S, Corcione F, Del Genio G, Ferulano GP, Giardiello C, Livrea A, Marzano LA, Porcelli A, Sperlongano P, Vincenti R, Palazzo A, De Martino C, Musella M. Adrenal incidentalomas in the laparoscopic era and the role of correct surgical indications: observations from 255 consecutive adrenalectomies in an Italian series. Can J Surg 2009; 52: E281-E285
    PubMedGoogle Scholar
  • 48 Lupascu C, Tarcoveanu E, Bradea C, Andronic D, Ursulescu C, Niculescu D. Laparoscopic adrenalectomy for large solid cortical tumours – is it appropriate?. Chirurgia (Bucur) 2011; 106: 315-320
    PubMedGoogle Scholar
  • 49 Gaujoux S, Bonnet S, Leconte M, Zohar S, Bertherat J, Bertagna X, Dousset B. Risk factors for conversion and complications after unilateral laparoscopic adrenalectomy. Br J Surg 2011; 98: 1392-1399
    CrossrefPubMedGoogle Scholar