Dong Dexin, Li Hanzhong, Yan Weigang, Ji Zhigang, Mao Quanzong
Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.
Urol Int. 2012;88(4):400-4. doi: 10.1159/000336134. Epub 2012 Apr 5.
To study the relationship between surgical management and prognosis of adrenocortical carcinoma (ACC) in order to guide the surgical management of ACC.
Clinical data of 45 cases of ACC treated in our hospital were retrospectively analyzed. The 45 cases included 3 cases in stage I, 12 cases in stage II, 7 cases in stage III, and 23 cases in stage IV. 17 cases underwent complete excision, 14 cases underwent palliative excision, 8 cases had non-operative treatment and 6 cases gave up treatment. All patients were followed up from 2 to 141 months.
The average survival time of 31 patients with surgery was 32.46 months, and the average survival time of 14 patients without surgery was 4.75 months. There were statistically significant differences between the two groups (p < 0.01). There were no statistically significant differences between the two groups in survival time in stage III and stage IV (p > 0.05).
Surgery is considered to be the only method to cure ACC. For ACC in stage I and II, tumor resection is the most effective treatment, and second surgical operation is recommended for local recurrence. For ACC in stage III, extensive surgical operation is recommended, and for ACC in stage IV, surgical operation has no effect on the prognosis.
研究肾上腺皮质癌（ACC）的手术治疗与预后的关系，以指导ACC的手术治疗。
回顾性分析我院收治的45例ACC患者的临床资料。45例中，Ⅰ期3例，Ⅱ期12例，Ⅲ期7例，Ⅳ期23例。17例行根治性切除，14例行姑息性切除，8例非手术治疗，6例放弃治疗。所有患者随访2至141个月。
31例手术患者的平均生存时间为32.46个月，14例未手术患者的平均生存时间为4.75个月。两组间差异有统计学意义（p<0.01）。Ⅲ期和Ⅳ期两组患者生存时间差异无统计学意义（p>0.05）。
手术被认为是治愈ACC的唯一方法。对于Ⅰ期和Ⅱ期ACC，肿瘤切除是最有效的治疗方法，局部复发建议再次手术。对于Ⅲ期ACC，建议行广泛手术，对于Ⅳ期ACC，手术对预后无影响。
