Cargando…

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...

Descripción completa

Detalles Bibliográficos
Autores principales: Barac Nekic, Anja, Knezevic, Nikola, Zibar Tomsic, Karin, Kraljevic, Ivana, Balasko, Annemarie, Skoric Polovina, Tanja, Solak, Mirsala, Dusek, Tina, Kastelan, Darko
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
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
_version_ 1784637801660153856
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
work_keys_str_mv AT baracnekicanja theeffectofsurgeonexpertiseontheoutcomeofpatientswithadrenocorticalcarcinoma
AT knezevicnikola theeffectofsurgeonexpertiseontheoutcomeofpatientswithadrenocorticalcarcinoma
AT zibartomsickarin theeffectofsurgeonexpertiseontheoutcomeofpatientswithadrenocorticalcarcinoma
AT kraljevicivana theeffectofsurgeonexpertiseontheoutcomeofpatientswithadrenocorticalcarcinoma
AT balaskoannemarie theeffectofsurgeonexpertiseontheoutcomeofpatientswithadrenocorticalcarcinoma
AT skoricpolovinatanja theeffectofsurgeonexpertiseontheoutcomeofpatientswithadrenocorticalcarcinoma
AT solakmirsala theeffectofsurgeonexpertiseontheoutcomeofpatientswithadrenocorticalcarcinoma
AT dusektina theeffectofsurgeonexpertiseontheoutcomeofpatientswithadrenocorticalcarcinoma
AT kastelandarko theeffectofsurgeonexpertiseontheoutcomeofpatientswithadrenocorticalcarcinoma
AT theeffectofsurgeonexpertiseontheoutcomeofpatientswithadrenocorticalcarcinoma
AT baracnekicanja effectofsurgeonexpertiseontheoutcomeofpatientswithadrenocorticalcarcinoma
AT knezevicnikola effectofsurgeonexpertiseontheoutcomeofpatientswithadrenocorticalcarcinoma
AT zibartomsickarin effectofsurgeonexpertiseontheoutcomeofpatientswithadrenocorticalcarcinoma
AT kraljevicivana effectofsurgeonexpertiseontheoutcomeofpatientswithadrenocorticalcarcinoma
AT balaskoannemarie effectofsurgeonexpertiseontheoutcomeofpatientswithadrenocorticalcarcinoma
AT skoricpolovinatanja effectofsurgeonexpertiseontheoutcomeofpatientswithadrenocorticalcarcinoma
AT solakmirsala effectofsurgeonexpertiseontheoutcomeofpatientswithadrenocorticalcarcinoma
AT dusektina effectofsurgeonexpertiseontheoutcomeofpatientswithadrenocorticalcarcinoma
AT kastelandarko effectofsurgeonexpertiseontheoutcomeofpatientswithadrenocorticalcarcinoma
AT effectofsurgeonexpertiseontheoutcomeofpatientswithadrenocorticalcarcinoma