Department of Surgery, University of Miami Miller School of Medicine, Miami, FL, USA.
Miami Transplant Institute, University of Miami Miller School of Medicine, Jackson Memorial Hospital, 1801 NW 9th Ave, 7th Floor, Miami, FL, 33136, USA.
Langenbecks Arch Surg. 2023 Feb 13;408(1):87. doi: 10.1007/s00423-023-02827-2.
The surgical treatment for adrenocortical carcinoma with venous tumor invasion remains a challenge for surgeons. A critical factor in determining the surgical approach is utilizing a classification system that accurately defines the tumor thrombus level.
Olivero and colleagues report their experience regarding the feasibility of mini-invasive surgery for adrenocortical carcinoma with venous tumor invasion. They studied the outcome of 20 patients from 4 international referral center databases.
They describe a classification for adrenal tumor with tumor thrombus into four levels: (1) adrenal vein invasion; (2) renal vein invasion; (3) infra-hepatic inferior vena cava (IVC); and (4) retro-hepatic IVC.
We congratulate the authors for their work and patient outcomes; however, in efforts to avoid confusion in the surgical community, we believe their classification system requires modification compared to our classification system developed in 2004.
对于伴有静脉肿瘤侵犯的肾上腺皮质癌，手术治疗仍然是外科医生面临的挑战。在确定手术方法时，一个关键因素是利用能够准确定义肿瘤血栓水平的分类系统。
Olivero 及其同事报告了他们在伴有静脉肿瘤侵犯的肾上腺皮质癌的微创治疗方面的经验。他们研究了来自 4 个国际转诊中心数据库的 20 例患者的结果。
他们描述了一种将肾上腺肿瘤伴肿瘤血栓分为 4 个等级的分类法：（1）肾上腺静脉侵犯；（2）肾静脉侵犯；（3）肝下下腔静脉（IVC）；（4）肝后 IVC。
我们祝贺作者的工作和患者的结果；然而，为了避免在外科界引起混淆，我们认为与我们 2004 年制定的分类系统相比，他们的分类系统需要修改。
