ECE2010 Poster Presentations Endocrine tumours & neoplasia (<emphasis role="italic">Generously supported by Novartis</emphasis>) (82 abstracts)
Adrenocortical carcinoma: is the surgical approach a risk factor of peritoneal carcinomatosis?
Sophie Leboulleux 1 , Désirée Deandreis 1 , Abir Al Ghuzlan 1 , Anne Aupérin 1 , Clarisse Dromain 1 , Jacques Young 2 , Martin Schlumberger 1 & Eric Baudin 1
1Institut Gustave Roussy, Villejuif, France; 2Service d’Endocrinologie et des Maladies de la Reproduction, Kremlin Bicetre, France.
Context: Peritoneal carcinomatosis (PC) is a rare site of distant metastasis in patients with adrenocortical cancer (ACC). One preliminary study suggests an increase risk of PC after adrenalectomy through laparoscopic approach of ACC.
Objective: The objective of the study was to search for risk factors of PC including surgical approach. 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 in 32 cases, stage III in 7 cases, stage IV in 21 cases and unknown stage in 2 cases. Surgery was open in 58 cases and laparoscopic in 6 cases.
Results: PC occurred in 18 (28%) patients. It was present at initial diagnosis in 3 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% (95CI, 30–90%) for laparoscopic adrenalectomy and 27% (95CI, 15–44%) for open adrenalectomy (P=0.016). Neither tumor size, stage, functional status, completeness of surgery or plasmatic level of op’DDD were associated with the occurrence of PC.
Conclusion: We found an increase risk of PC after laparoscopic adrenalectomy of ACC. Adrenal tumors bearing malignant characteristics preoperatively should be referred for open adrenalectomy.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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