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. 2022 Jan 13;12(1):100.
doi: 10.3390/jpm12010100.

The Effect of Surgeon Expertise on the Outcome of Patients with Adrenocortical Carcinoma

Anja Barac Nekic  1 , Nikola Knezevic  2   3 , Karin Zibar Tomsic  4 , Ivana Kraljevic  3   4 , Annemarie Balasko  4 , Tanja Skoric Polovina  4 , Mirsala Solak  4 , Tina Dusek  3   4 , Darko Kastelan  3   4 , Croatian Acc Study Group
Affiliations

The Effect of Surgeon Expertise on the Outcome of Patients with Adrenocortical Carcinoma

Anja Barac Nekic et al. J Pers Med. .

Abstract

Complete surgical removal of adrenocortical carcinoma (ACC) represents the only chance of long-term cure. In this study, we compared the long-term outcomes of ACC patients depending on whether they had adrenal surgery performed in a high-volume (HVC) or in a low-volume (LVC) center. This retrospective study included 49 patients from the Croatian ACC Registry with the European Network for the Study of Adrenal Tumors (ENSAT) stage I-III ACC, of which 35 underwent surgery in a HVC whereas 14 of them were operated in one of the LVCs. Patients operated in the LVCs had a significantly higher rate of ACC recurrence (57.1% vs. 22.9%; p = 0.02). Accordingly, RFS was significantly longer in patients operated on in HVC (p = 0.04). The difference in RFS remained significant after controlling for age, gender, tumor size, Ki-67 index, Weiss score, and type of surgery (HR 4.55; 95% CI 1.16-17.88; p = 0.03). In addition, there is a tendency towards longer DSS in patients in the HVC group compared to those in the LVC group (p = 0.05). These results point to the centralization of adrenal surgery as a key prerequisite for improving the outcomes of ACC patients.

Keywords: adrenal surgery; adrenocortical carcinoma; patient outcome.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Recurrence free survival.
Figure 2
Figure 2
Disease specific survival.
See this image and copyright information in PMC

References

    1. Kastelan D., Muzurovic E., Dusek T. Approach to Patients with European Network for the Study of Adrenal Tumor Stages I and II Adrenocortical Carcinomas. Curr. Opin. Endocrinol. Diabetes Obes. 2021;28:265–270. doi: 10.1097/MED.0000000000000626. - DOI - PubMed
    1. Stavrakis A.I., Ituarte P.H.G., Ko C.Y., Yeh M.W. Surgeon Volume as a Predictor of Outcomes in Inpatient and Outpatient Endocrine Surgery. Surgery. 2007;142:887–899. doi: 10.1016/j.surg.2007.09.003. - DOI - PubMed
    1. Villar J.M., Moreno P., Ortega J., Bollo E., Ramírez C.P., Muñoz N., Martínez C., Domínguez-Adame E., Sancho J., Del Pino J.M., et al. Results of Adrenal Surgery. Data of a Spanish National Survey. Langenbeck’s Arch. Surg. 2010;395:837–843. doi: 10.1007/s00423-010-0697-z. - DOI - PubMed
    1. Lombardi C.P., Raffaelli M., Boniardi M., De Toma G., Marzano L.A., Miccoli P., Minni F., Morino M., Pelizzo M.R., Pietrabissa A., et al. Adrenocortical Carcinoma: Effect of Hospital Volume on Patient Outcome. Langenbeck’s Arch. Surg. 2012;397:201–207. doi: 10.1007/s00423-011-0866-8. - DOI - PubMed
    1. Palazzo F., Dickinson A., Phillips B., Sahdev A., Bliss R., Rasheed A., Krukowski Z., Newell-Price J. Adrenal Surgery in England: Better Outcomes in High-Volume Practices. Clin. Endocrinol. 2016;85:17–20. doi: 10.1111/cen.13021. - DOI - PubMed

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