Zhao Xin, Zhou Jiaquan, Lyu Xiaohong, Li Yanan, Liu Yihong, Zhang Yushi
Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.
Department of Urology, Hainan Affiliated Hospital of Hainan Medical University (Hainan General Hospital), Haikou, Hainan, China.
Int J Urol. 2025 May;32(5):493-501. doi: 10.1111/iju.15678. Epub 2025 Jan 21.
It was controversial to use open surgery or minimally invasive surgery (MIS) for adrenocortical carcinoma (ACC). This retrospective study aimed to evaluate the impact on prognosis between MIS and open surgery in patients with clinical stage I-II ACC.
Patients with stage I-II ACC from December 2000 to October 2022 were retrospectively studied. The primary endpoint was recurrence-free survival time calculated by the Kaplan-Meier curves.
In total, 95 patients were enrolled in this study (50 open surgery and 45 MIS). Propensity score matching identified 32 matched pairs of patients. Compared with the open surgery group, the MIS group had a shorter median operative time (150.0 vs. 120.0 min, p = 0.014), the lesser median volume of intraoperative blood loss (200.0 vs. 60.0 mL, p = 0.006), lower incidence of postoperative complications (59.4% vs. 28.1%, p = 0.023), and shorter median postoperative length of hospital stay (8.0 vs. 7.0 days, p = 0.001). After a median follow-up time of 20.5 months, no significant differences were observed in the local recurrence rate (62.5% vs. 78.1%), distant metastasis rate (15.6% vs. 6.3%), and median time to recurrence (15.0 vs. 20.0 months) between the two groups. The median recurrence-free survival time between the open surgery and MIS groups did not significantly differ (16.0 vs. 21.0 months).
MIS might be a feasible option for treating localized ACC at a high patient's volume center with experienced surgeons.
