Background: In the management of adrenal lesions in oncological patients, many issues are still controversial: morphological signs of suspected malignancy, accuracy of imaging examinations, use of fine needle aspiration (FNA), and the role of laparoscopy. The present study attempts to address these questions through the evaluation of the management of adrenal metastases (AM) in a wide cohort of patients included in the Italian Register of Endoscopic Adrenal Surgery. Methods: In January 2009, all patients recorded on the Register were evaluated, on the basis of CT scan, MRI, and FNA. The diagnostic, surgical, and follow-up data of 95 patients with pre-operative AM diagnosis have been reviewed. On the basis of the fulfilled criteria three patterns were identified: "diagnostic", "suspect," and "non-diagnostic." Results: CT scan sensitivity was 41.5%/77.9% and specificity was 54.5%/90.9% for "diagnostic"/"diagnostic" + "suspect" examinations, respectively. MRI sensitivity was 15.7%/78.9% and specificity was non-determinate/83.3% for "diagnostic"/ "diagnostic" + "suspect" exams, respectively. Sensitivity of FNA was 33.3%. About surgery, conversions rate was 16.6%; no mortality or re-operations were reported; complications rate was 10.7%; and no relation was noted between tumor size and surgical outcome. Mean survival was 32 months; 5-year survival was 23%, independent of AM size; survival for lung AM was similar to that of breast and kidney AM. Conclusions: Laparoscopy for AM, in expert hand, seems to be a feasible and oncologically safe approach. Due to the unsatisfactory diagnostic accuracy for AM, every oncological patient with suspect adrenal lesions should be encouraged to undergo this surgical procedure. © 2010 Wiley-Liss, Inc.

A multi-center study on the surgical management of metastatic disease to adrenal glands / Valeri A.; Bergamini C.; Tozzi F.; Martellucci J.; Di Costanzo F.; Antonuzzo L.. - In: JOURNAL OF SURGICAL ONCOLOGY. - ISSN 0022-4790. - ELETTRONICO. - 103:(2011), pp. 400-405. [10.1002/jso.21843]

A multi-center study on the surgical management of metastatic disease to adrenal glands

Di Costanzo F.;Antonuzzo L.
Writing – Review & Editing
2011

Abstract

Background: In the management of adrenal lesions in oncological patients, many issues are still controversial: morphological signs of suspected malignancy, accuracy of imaging examinations, use of fine needle aspiration (FNA), and the role of laparoscopy. The present study attempts to address these questions through the evaluation of the management of adrenal metastases (AM) in a wide cohort of patients included in the Italian Register of Endoscopic Adrenal Surgery. Methods: In January 2009, all patients recorded on the Register were evaluated, on the basis of CT scan, MRI, and FNA. The diagnostic, surgical, and follow-up data of 95 patients with pre-operative AM diagnosis have been reviewed. On the basis of the fulfilled criteria three patterns were identified: "diagnostic", "suspect," and "non-diagnostic." Results: CT scan sensitivity was 41.5%/77.9% and specificity was 54.5%/90.9% for "diagnostic"/"diagnostic" + "suspect" examinations, respectively. MRI sensitivity was 15.7%/78.9% and specificity was non-determinate/83.3% for "diagnostic"/ "diagnostic" + "suspect" exams, respectively. Sensitivity of FNA was 33.3%. About surgery, conversions rate was 16.6%; no mortality or re-operations were reported; complications rate was 10.7%; and no relation was noted between tumor size and surgical outcome. Mean survival was 32 months; 5-year survival was 23%, independent of AM size; survival for lung AM was similar to that of breast and kidney AM. Conclusions: Laparoscopy for AM, in expert hand, seems to be a feasible and oncologically safe approach. Due to the unsatisfactory diagnostic accuracy for AM, every oncological patient with suspect adrenal lesions should be encouraged to undergo this surgical procedure. © 2010 Wiley-Liss, Inc.
2011
103
400
405
Valeri A.; Bergamini C.; Tozzi F.; Martellucci J.; Di Costanzo F.; Antonuzzo L.
File in questo prodotto:
File Dimensione Formato  
jso.21843.pdf

Accesso chiuso

Tipologia: Pdf editoriale (Version of record)
Licenza: Tutti i diritti riservati
Dimensione 243.18 kB
Formato Adobe PDF
243.18 kB Adobe PDF   Richiedi una copia

I documenti in FLORE sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificatore per citare o creare un link a questa risorsa: https://hdl.handle.net/2158/1193468
Citazioni
  • ???jsp.display-item.citation.pmc??? ND
  • Scopus 16
  • ???jsp.display-item.citation.isi??? 14
social impact