title: Does nephrectomy during radical adrenalectomy for stage II adrenocortical cancer affect patient outcome?
abstract: OBJECTIVE
  To evaluate if including nephrectomy in the standard surgical approach to stage II adrenocortical cancer (i.e., adrenalectomy) might modify oncologic outcome of patients.
  
  
  METHODS
  We performed a retrospective analysis involving 41 patients with stage II adrenocortical cancer (ACC) who had undergone radical surgery. Patients were divided into two groups according to the surgical procedure: group A = radical adrenalectomy alone, group AN = radical adrenalectomy + radical nephrectomy. Oncologic effectiveness of the procedures was tested comparing the recurrence-free and overall survival of patients of A vs AN groups.
  
  
  RESULTS
  The group A consisted of 25 patients and group AN of 16 patients. No differences were noted between the two groups in terms of demographic data and ACC characteristics. During follow-up, 15/25 (60 %) patients of group A vs 14/16 (87.5 %) patients of group AN experienced a recurrence, after a median of 36 months in group A and 10 months in group AN (p = 0.06); a significant impairment of renal function was recorded in patients of AN group with respect to those of group A. Finally, 13/25 (52 %) patients of group A and 10/16 (62.5 %) patients of group AN died due to ACC-related causes. No differences in survival times were noted (p = 0.3).
  
  
  CONCLUSIONS
  Our study suggests that adjunctive nephrectomy does not modify the oncologic results of adrenalectomy in the treatment of stage II ACC in terms of recurrence-free and overall survival. Thus, when there are no signs of ACC local invasion, surgeon should make every effort to preserve the kidney.
authors.affiliation: Division of Urology, Department of Oncology, "San Luigi" Hospital-Orbassano, University of Turin, Regione Gonzole 10, 10043, Orbassano, TO, Italy. porpiglia@libero.it.
authors.forename: F
authors.initials: F
authors.lastname: Porpiglia
authors.affiliation: Division of Urology, Department of Oncology, "San Luigi" Hospital-Orbassano, University of Turin, Regione Gonzole 10, 10043, Orbassano, TO, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Fiori
authors.affiliation: Division of Internal Medicine, Department of Oncology, "San Luigi" Hospital-Orbassano, University of Turin, Orbassano, TO, Italy.
authors.forename: F C
authors.initials: FC
authors.lastname: Daffara
authors.affiliation: Division of Internal Medicine, Department of Oncology, "San Luigi" Hospital-Orbassano, University of Turin, Orbassano, TO, Italy.
authors.forename: B
authors.initials: B
authors.lastname: Zaggia
authors.affiliation: Division of Internal Medicine, Department of Oncology, "San Luigi" Hospital-Orbassano, University of Turin, Orbassano, TO, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Ardito
authors.affiliation: Division of Urology, Department of Oncology, "San Luigi" Hospital-Orbassano, University of Turin, Regione Gonzole 10, 10043, Orbassano, TO, Italy.
authors.forename: R M
authors.initials: RM
authors.lastname: Scarpa
authors.affiliation: Division of Pathology, Department of Oncology, "San Luigi" Hospital-Orbassano, University of Turin, Orbassano, TO, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Papotti
authors.affiliation: Medical Oncology Unit, Department of Medical & Surgical Specialties, Radiological Sciences & Public Health, University of Brescia at Spedali Civili Hospital, Brescia, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Berruti
authors.affiliation: Division of Oncology, Department of Oncology, "San Luigi" Hospital-Orbassano, University of Turin, Orbassano, TO, Italy.
authors.forename: G V
authors.initials: GV
authors.lastname: Scagliotti
authors.affiliation: Division of Internal Medicine, Department of Oncology, "San Luigi" Hospital-Orbassano, University of Turin, Orbassano, TO, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Terzolo
mesh_terms: D000306:Adrenal Cortex Neoplasms / Q000473:pathology / Q000601:surgery*; D000310:Adrenal Gland Neoplasms / Q000473:pathology / Q000601:surgery*; D000315:Adrenalectomy / Q000401:mortality*; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000601:surgery*; D009367:Neoplasm Staging; D009392:Nephrectomy / Q000401:mortality*; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D055815:Young Adult
keywords: Adrenocortical cancer; Nephrectomy; Radical adrenalectomy; Surgery