engleski

The effect of surgeon’s experience on the outcome of patients with ACC

Introduction: Adrenocortical carcinoma (ACC)is a rare disease with an unfavourable prognosis. Complete surgical resection of the tumour provides the only chance for long-term cure. The aim of this study was to compare long term outcomes in patients with ACC referred to surgery in an expert adrenal centre (EC) versus nonspecialised centres (NSC). Materials and methods: This retrospective study included 48 patients with ACC, ENSAT stage I-III. All of study participants underwent complete tumour resection of whom 35 (73%) were operated in a high-volume centre by a dedicated surgeon, whereas 13 (27%) patients were operated in nonspecialised centres. The study analysed the differences between the two groups in terms of recurrence free survival (RFS) and overall survival (OS). Results: Median duration of follow- up was 51 months (5–174) in EC group and 46 months (3–165) in NSC group. Disease recurrence was observed in 5 (14.3%) patients in the EC group and in 5 (38.5%) patients in the NSC group (P = 0.067). Patients in the EC group had longer PFS but the difference did not reached the level of statistical significance (28 (11–45) month vs 19 (3–43) months ; P = 0.083). Overall, seven patients died during follow-up (5 EC, 2 NSC). ACC was the cause of death in two EC patients (5.7%) and in two NSC patients (15.4% ; P = 0.16). Conclusion: The above-mentioned results show thatACC recurrence is less likely to occur in patients operated by a dedicated surgeon in an expert adrenal centre.

Surgeon’s experience ; Adrenocortical carcinoma

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