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The Effect of Surgeon Expertise on the Outcome of Patients with Adrenocortical Carcinoma
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 retrospecti...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8780290/ https://www.ncbi.nlm.nih.gov/pubmed/35055415 http://dx.doi.org/10.3390/jpm12010100 |
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author | Barac Nekic, Anja Knezevic, Nikola Zibar Tomsic, Karin Kraljevic, Ivana Balasko, Annemarie Skoric Polovina, Tanja Solak, Mirsala Dusek, Tina Kastelan, Darko |
author_facet | Barac Nekic, Anja Knezevic, Nikola Zibar Tomsic, Karin Kraljevic, Ivana Balasko, Annemarie Skoric Polovina, Tanja Solak, Mirsala Dusek, Tina Kastelan, Darko |
author_sort | Barac Nekic, Anja |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-8780290 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-87802902022-01-22 The Effect of Surgeon Expertise on the Outcome of Patients with Adrenocortical Carcinoma Barac Nekic, Anja Knezevic, Nikola Zibar Tomsic, Karin Kraljevic, Ivana Balasko, Annemarie Skoric Polovina, Tanja Solak, Mirsala Dusek, Tina Kastelan, Darko J Pers Med Article 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. MDPI 2022-01-13 /pmc/articles/PMC8780290/ /pubmed/35055415 http://dx.doi.org/10.3390/jpm12010100 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Barac Nekic, Anja Knezevic, Nikola Zibar Tomsic, Karin Kraljevic, Ivana Balasko, Annemarie Skoric Polovina, Tanja Solak, Mirsala Dusek, Tina Kastelan, Darko The Effect of Surgeon Expertise on the Outcome of Patients with Adrenocortical Carcinoma |
title | The Effect of Surgeon Expertise on the Outcome of Patients with Adrenocortical Carcinoma |
title_full | The Effect of Surgeon Expertise on the Outcome of Patients with Adrenocortical Carcinoma |
title_fullStr | The Effect of Surgeon Expertise on the Outcome of Patients with Adrenocortical Carcinoma |
title_full_unstemmed | The Effect of Surgeon Expertise on the Outcome of Patients with Adrenocortical Carcinoma |
title_short | The Effect of Surgeon Expertise on the Outcome of Patients with Adrenocortical Carcinoma |
title_sort | effect of surgeon expertise on the outcome of patients with adrenocortical carcinoma |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8780290/ https://www.ncbi.nlm.nih.gov/pubmed/35055415 http://dx.doi.org/10.3390/jpm12010100 |
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