Open adrenalectomy versus laparoscopic adrenalectomy for adrenocortical carcinoma: a retrospective comparative study on short-term oncologic prognosis

Figures & data

Table 1 Baseline characteristics of 42 patients with ACC treated with OA and LA

Baseline characteristics	OA group	LA group	P-value
No of patients	22	20
Age, years, mean ± SD (95% CI)	48.5±14.1 (42.2–54.7)	45.2±10.9 (40.1–50.3)	0.400
Sex, n (male/female)	10/12	9/11	0.900
Endocrine function, n (%)			0.200
Non-function	9 (40.9)	9 (45)
Cortisol	6 (27.3)	8 (40)
Sexual steroid	4 (18.2)	0 (0)
Cortisol plus sexual steroid	3 (13.6)	3 (15)
Max diameter, cm			0.001
Mean ± SD (95% CI)	10.1±3.6 (8.4–11.6)	6.3±2.2 (5.3–7.6)
Tumor stage, n (%)			0.100
Stage I	1 (4.5)	5 (25)
Stage II	12 (54.5)	11 (55)
Stage III	9 (40.9)	4 (20)
Ki-67 index (%), median (range)	20 (6.25–40)	15 (2.75–25)	0.400

Abbreviations: ACC, adrenocortical carcinoma; LA, laparoscopic adrenalectomy; OA, open adrenalectomy.

Table 2 Perioperative data of 42 patients with ACC treated with OA and LA

Perioperative indexes	OA group	LA group	P-value
Operative time, minutes			0.004
Median (range)	175.0 (144.0–198.5)	130.0 (100.0–153.5)
Bleeding volume, mL			0.001
Median (range)	800 (200–1,250)	70 (25–400)
Postoperative hospitalization, days			0.018
Median (range)	9.5 (7.0–12.5)	7.0 (6.0–8.0)
Complications, n (%)			0.800
Grade 1–2	9 (40.9)	7 (35)
Grade 3–4	0 (0)	0 (0)
Death	1 (4.5)	0 (0)

Abbreviations: ACC, adrenocortical carcinoma; LA, laparoscopic adrenalectomy; OA, open adrenalectomy.

Table 3 Short-term oncologic prognosis of patients undergoing OA and LA

Short-term prognosis	OA group	LA group	P-value
Disease-free survival, months
Mean ± SD (95% CI)	44.8±35.1 (26.1–63.5)	17.5±10.4 (11.4–23.5)	0.023
1-year DFS, n/T (rate)	15/19 (78.9%)	10/16 (62.5%)	0.400
2-year DFS, n/T (rate)	11/18 (61.1%)	3/14 (21.4%)	0.036
3-year DFS, n/T (rate)	4/17 (23.5%)	3/14 (21.4%)	0.600
First recurrence sites	13	11	0.080
Local	5	8
Distant	5	0	0.030
Local and distant	3	3

Abbreviations: DFS, disease-free survival; LA, laparoscopic adrenalectomy; OA, open adrenalectomy; T, total cases available to be evaluated.

Figure 1 Kaplan–Meier analysis of disease-free survival of patients showing first recurrence after open adrenalectomy versus laparoscopic adrenalectomy.

Figure 2 Kaplan–Meier analysis of disease-free survival of all the patients involved in the study undergoing open adrenalectomy (OA) versus laparoscopic adrenalectomy (LA).