PD07-09 ADRENOCORTICAL CARCINOMA WITH VENOUS TUMOR INVASION. IS THERE A ROLE FOR MINI-INVASIVE SURGERY?

Abstract

You have accessJournal of UrologyAdrenal (PD07)1 Sep 2021PD07-09 ADRENOCORTICAL CARCINOMA WITH VENOUS TUMOR INVASION. IS THERE A ROLE FOR MINI-INVASIVE SURGERY? Alberto Olivero, Kan Liu, Enrico Checcucci, Lei Liu, Lulin Ma, Guoliang Wang, Guglielmo Mantica, Stefano Tappero, Daniele Amparore, Michele Sica, Cristian Fiori, Quingbo Huang, Shaoxi Niu, Baojun Wang, Xin Ma, Xiaofei Hou, Francesco Porpiglia, Carlo Terrone, and Xu Zhang Alberto OliveroAlberto Olivero More articles by this author , Kan LiuKan Liu More articles by this author , Enrico CheccucciEnrico Checcucci More articles by this author , Lei LiuLei Liu More articles by this author , Lulin MaLulin Ma More articles by this author , Guoliang WangGuoliang Wang More articles by this author , Guglielmo ManticaGuglielmo Mantica More articles by this author , Stefano TapperoStefano Tappero More articles by this author , Daniele AmparoreDaniele Amparore More articles by this author , Michele SicaMichele Sica More articles by this author , Cristian FioriCristian Fiori More articles by this author , Quingbo HuangQuingbo Huang More articles by this author , Shaoxi NiuShaoxi Niu More articles by this author , Baojun WangBaojun Wang More articles by this author , Xin MaXin Ma More articles by this author , Xiaofei HouXiaofei Hou More articles by this author , Francesco PorpigliaFrancesco Porpiglia More articles by this author , Carlo TerroneCarlo Terrone More articles by this author , and Xu ZhangXu Zhang More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001975.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Venous invasion(VI) from adrenocortical carcinoma(ACC) is a rare presentation of a very rare malignancy and is a poor prognostic feature. There is limited evidence in the treatment of advanced adrenal carcinoma using a mini-invasive(MI) approach. This study aims is to investigate early oncologic outcomes in patients with ACC with VI accordingly to the surgical approach applied. METHODS: We conducted a retrospective analysis of 4 international referral centers databases, including all the patients undergoing Adrenalectomy for ACC with VI from 2007 to March 2020. Patients’ demographics, lesion characteristics, perioperative, pathology, and oncological data were analyzed. From the preoperative imaging, we classified the thrombus invasion in 4 levels: 1 Adrenal vein invasion; 2 Renal vein invasion; 3 infra-hepatic IVC; 4 retro-hepatic IVC. We divided our patients into 2 groups: patients undergone open surgery and patients treated with MI surgery. A Kaplan–Meier plot was used to describe the disease-free(DFS) and overall survival(OS) between the groups. RESULTS: We identified 20 patients with a median follow-up of 12 months. Nine were male with a median age of 51 years. Nine patients (45%) presented a right disease. The median tumor size was 110 mm. ENSAT stage was II in 4 patients, III in 13 patients, and IV in 3 patients. Tumor thrombus extended in the adrenal vein(n=5), renal vein(n=1), infra-hepatic IVC(n=9) or into the retro-hepatic IVC(n=5). Ten patients were treated with MI approach (5 robotic and 5 laparoscopic). A worse disease was reported in the open group. The two groups did not differ in terms of surgical margins, surgical time, blood losses, complications, and length of stay. Accordingly to the more aggressive disease, the prognosis was worse in the open group. Full patients’ characteristics and outcomes are reported in the Table.Kaplan-Meier analysis indicated a difference in OS for the patients stratified by ENSAT stage (p=0.011), we also reported a difference in DFS for patient stratified for thrombus extension(p=0.004) and ENSAT stage(p <0.001). CONCLUSIONS: The DFS of patients with VI from ACC is influenced by the staging and the extension of the venous invasion; the OS is influenced by the staging. The MI approach seems to be feasible and safe in selected patients without influence oncological outcomes. Source of Funding: - © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e108-e109 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Alberto Olivero More articles by this author Kan Liu More articles by this author Enrico Checcucci More articles by this author Lei Liu More articles by this author Lulin Ma More articles by this author Guoliang Wang More articles by this author Guglielmo Mantica More articles by this author Stefano Tappero More articles by this author Daniele Amparore More articles by this author Michele Sica More articles by this author Cristian Fiori More articles by this author Quingbo Huang More articles by this author Shaoxi Niu More articles by this author Baojun Wang More articles by this author Xin Ma More articles by this author Xiaofei Hou More articles by this author Francesco Porpiglia More articles by this author Carlo Terrone More articles by this author Xu Zhang More articles by this author Expand All Advertisement Loading ...