Severity and management of hypercortisolism in patients with adrenocortical carcinoma and overt Cushing's syndrome.

Cancer research · Adrenocortical carcinoma

Comparative studies on different surgery approaches for adrenocortical carcinoma (ACC) remains controversial.

This retrospective study compared overall survival (OS) and disease‑free survival (DFS) between open adrenalectomy (OA) and laparoscopic adrenalectomy (LA) in patients with localized adrenocortical carcinoma (ACC) (stage I‑III). Propensity‑score matching was used to balance baseline characteristics. Survival analyses revealed no significant differences in OS or DFS between OA and LA, nor between trans‑abdominal (TLA) and retroperitoneal (RLA) approaches. Operative time and hospital stay were shorter with LA, but other peri‑operative outcomes, including tumor rupture, mortality, and recurrence, were comparable. T stage and tumor size emerged as independent predictors of poorer survival.

ACC is a rare but highly aggressive endocrine malignancy where optimal surgical strategy can influence long‑term survival outcomes; therefore, clear evidence supporting comparable oncologic efficacy between OA and LA is essential for guiding surgical decision‑making.

Evidence level: Klinikai vizsgálat. Formális klinikai vizsgálati eredmény.

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