Abstract：
BACKGROUND:The role of lymphadenectomy in adrenocortical carcinoma resection is controversial. Therefore, we conducted a population-based study to assess the association between positive lymph nodes (LN) and survival. METHODS:The Surveillance, Epidemiology, and End Results set of cancer registries were utilized. The associations between positive lymph nodes and tumor size, grade and laterality were assessed. Cancer specific survival (CSS) trends and factors affecting survival were analyzed. RESULTS:A total of 2170 adult patients were identified; 60% underwent resection. Among those resected, LN were examined in 23% and were positive in 25% of patients with LN examined. Patients with positive LN tended to have smaller tumors compared to those with negative LN (12 ± 5 vs 15 ± 11 cm, p = 0.02). The rate of positive LN was higher in right ACC, p = 0.03. Median overall CSS was 21 months, with significant differences between resection (42 months) and no resection (4 months), p < 0.01. Median CSS did not change over time when comparing ACC patients who underwent surgery before 2000, 2000-2009, and 2010-2016. On multivariable analysis including resection group, advanced age, grades III and IV, regional and distant stage, in addition to positive LN were associated with worse survival, p < 0.05. CONCLUSION:Lymphadenectomy is infrequently performed during ACC resection, and when performed, regional LN involvement tends to be associated with worse survival. Neoplasm size and grade were not associated with LN involvement and therefore, do not inform lymphadenectomy need. Further studies are needed to assess the indications for, and value of lymphadenectomy in ACC.
journal_name
World J Surgjournal_title
World journal of surgeryauthors
Sada A,Glasgow AE,Lyden ML,Thompson GB,Dy BM,McKenzie TJ,Habermann EBdoi
10.1007/s00268-020-05801-xsubject
Has Abstractpub_date
2021-01-01 00:00:00pages
188-194issue
1eissn
0364-2313issn
1432-2323pii
10.1007/s00268-020-05801-xjournal_volume
45pub_type
杂志文章abstract：BACKGROUND:Given surgery's inherent risks, a patient should be able to make the most informed decisions possible in selecting surgical treatment. However, there is little information on what factors patients deem important when choosing a surgeon. We performed a systematic review of the literature focused on how patien...
journal_title：World journal of surgery
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journal_title：World journal of surgery
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journal_title：World journal of surgery
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journal_title：World journal of surgery
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journal_title：World journal of surgery
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更新日期：2009-05-01 00:00:00
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pub_type： 临床试验,杂志文章,多中心研究,随机对照试验
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journal_title：World journal of surgery
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journal_title：World journal of surgery
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更新日期：2009-01-01 00:00:00
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journal_title：World journal of surgery
pub_type： 杂志文章,随机对照试验
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更新日期：2018-12-01 00:00:00
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journal_title：World journal of surgery
pub_type： 杂志文章
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更新日期：1989-09-01 00:00:00
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journal_title：World journal of surgery
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更新日期：2008-09-01 00:00:00
