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

Autori
Barac Nekic, Anja ; Knezevic, Nikola ; Zibar Tomsic, Karin ; Kraljevic, Ivana ; Balasko, Annemarie ; Skoric Polovina, Tanja ; Solak, Mirsala ; Dusek, Tina ; Kastelan, Darko ; Croatian ACC Study Group

Izvornik
Journal of Personalized Medicine (2075-4426) 12 (2022), 1; NA-NA

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, članak, znanstveni

Ključne riječi
adrenal surgery ; adrenocortical carcinoma ; patient outcome.

Sažetak
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.

Izvorni jezik
Engleski

POVEZANOST RADA