Abstract:
PURPOSE:Adrenocortical carcinoma (ACC) is a rare malignancy, usually diagnosed at an advanced stage when it has invaded or adhered to adjacent organs. We report our experience of performing combined liver and inferior vena cava (IVC) resection for ACC. METHODS:Six patients with clinical stage III (n = 4) or IV (n = 2) ACC underwent combined resection of the liver and IVC. Two patients underwent extended right hepatectomy, and four underwent segmentectomy. In four patients, the IVC was resected segmentally: it was replaced with expanded polytetrafluoroethylene (ePTFE) in three of these patients, and not reconstructed in one. In two patients, the IVC was partially resected and closed directly. RESULTS:Perioperative mortality was zero, and morbidity was 33.3%, with temporary liver failure in two patients and renal failure in one patient. Recurrence was found within 8.1 months in three (50%) of the six patients. The mean recurrence-free survival period was 20.1 +/- 7.7 months (95% confidence interval [CI]: 5.1-35.4), and the median survival time was 6.1 +/- 9.8 months (95% CI: 00-25.3). The 5-year disease-free survival rate was 16.7%. CONCLUSIONS:Patients with ACC involving both the liver and IVC are candidates for partial hepatectomy and segmental IVC resection. Resection affords the possibility of negative margins, acceptable perioperative morbidity and mortality, and prolonged survival in some patients.
journal_name
Surg Todayjournal_title
Surgery todayauthors
Ohwada S,Izumi M,Tanahashi Y,Kawate S,Hamada K,Tsutsumi H,Horiguchi J,Koibuchi Y,Takahashi T,Yamada Mdoi
10.1007/s00595-006-3404-5subject
Has Abstractpub_date
2007-01-01 00:00:00pages
291-7issue
4eissn
0941-1291issn
1436-2813journal_volume
37pub_type
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