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

Authors :
Anja Barac Nekic
Nikola Knezevic
Karin Zibar Tomsic
Ivana Kraljevic
Annemarie Balasko
Tanja Skoric Polovina
Mirsala Solak
Tina Dusek
Darko Kastelan
Croatian ACC Study Group
Source :
Journal of Personalized Medicine, Vol 12, Iss 1, p 100 (2022)
Publication Year :
2022
Publisher :
MDPI AG, 2022.

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.

Details

Language :
English
ISSN :
20754426
Volume :
12
Issue :
1
Database :
Directory of Open Access Journals
Journal :
Journal of Personalized Medicine
Publication Type :
Academic Journal
Accession number :
edsdoj.2562a25d394909b1f3efdb0007c7b9
Document Type :
article
Full Text :
https://doi.org/10.3390/jpm12010100