title: Surgical Management of Adrenocortical Carcinoma: An Evidence-Based Approach.
abstract: Adrenocortical carcinoma frequently presents with sequelae of steroid precursor overproduction and has a proclivity for aggressive local growth, early metastasis, and recurrence. En bloc surgical resection with negative margins is the cornerstone of therapy for localized disease, and re-resection has a role in selected recurrent cases. Presence of occult micrometastatic disease at the time of presentation is confirmed by frequent distant failure after apparent negative margin resection. Data for many aspects of therapy are limited or nonexistent. This review critically considers existing evidence with a particular focus on surgical management.
authors.affiliation: Division of Endocrine and Oncologic Surgery, Department of Surgery, University of Pennsylvania Perelman School of Medicine, 3400 Spruce Street, Philadelphia, PA 19104, USA.
authors.forename: Jashodeep
authors.initials: J
authors.lastname: Datta
authors.affiliation: Division of Endocrine and Oncologic Surgery, Department of Surgery, University of Pennsylvania Perelman School of Medicine, 3400 Spruce Street, Philadelphia, PA 19104, USA. Electronic address: robert.roses@uphs.upenn.edu.
authors.forename: Robert E
authors.initials: RE
authors.lastname: Roses
mesh_terms: D000306:Adrenal Cortex Neoplasms / Q000601:surgery*; D000315:Adrenalectomy / Q000379:methods*; D018268:Adrenocortical Carcinoma / Q000601:surgery*; D019317:Evidence-Based Medicine; D006801:Humans
keywords: Adrenalectomy; Adrenocortical carcinoma; Laparoscopic; Localized; Metastatic; Multimodality; Recurrence; Surgery