Agathe Rémond, Camille Marciniak, Xavier Lenne, Vincent Chouraki, Mathilde Gobert, Gregory Baud, Laure Maillard, Damien Bouriez, Ellen Liekens, Gianluca Donatini, Claire Nominé-Criqui, Ambroise Ravenet, Nicolas Santucci, Paulina Kuczma, Nicolas Bouviez, Christophe Tresallet, Eric Mirallié, Sophie Deguelte, Laurent Brunaud, Carole Guerin, Caroline Gronnier, Jean-Christophe Lifante, Amélie Bruandet, Didier Theis, Alexis Cortot, Arnaud Scherpereel, Aghiles Hamroun, François Pattou, Robert Caiazzo
{"title":"继发性恶性肿瘤肾上腺切除术后的存活率和预后因素：对法国大学中心登记的 307 例患者（Eurocrine ®）和法国全国 2,515 例患者研究的综合分析。","authors":"Agathe Rémond, Camille Marciniak, Xavier Lenne, Vincent Chouraki, Mathilde Gobert, Gregory Baud, Laure Maillard, Damien Bouriez, Ellen Liekens, Gianluca Donatini, Claire Nominé-Criqui, Ambroise Ravenet, Nicolas Santucci, Paulina Kuczma, Nicolas Bouviez, Christophe Tresallet, Eric Mirallié, Sophie Deguelte, Laurent Brunaud, Carole Guerin, Caroline Gronnier, Jean-Christophe Lifante, Amélie Bruandet, Didier Theis, Alexis Cortot, Arnaud Scherpereel, Aghiles Hamroun, François Pattou, Robert Caiazzo","doi":"10.1097/SLA.0000000000006479","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To provide a nationwide description of postoperative outcomes and analysis of prognostic factors following adrenalectomy for metastases.</p><p><strong>Background: </strong>Adrenal glands are a common site of metastases in many malignancies. Diagnosis of adrenal metastases is on the rise, leading to an increasing number of patient candidates for surgery without consensual management.</p><p><strong>Methods: </strong>We conducted a population-based study between January 2012 and December 2022 using the French National Health Data System (SNDS) and the Eurocrine registry (NCT03410394). The first database exhaustively covers all procedures carried out in France, while the second provides more clinical information on procedures and tumor characteristics, based on the experience of 11 specialized centers.</p><p><strong>Results: </strong>From the SNDS, we extracted 2515 patients who underwent adrenalectomy for secondary malignancy and 307 from the Eurocrine database. The most common primary malignancies were lung cancer (n=1203, 47.8%) and renal cancer (n=555, 22.1%). One-year survival was 84.3% (n=2120). Thirty-day mortality and morbidity rates were, respectively, 1.3% (n=32) and 29.9% (n=753, including planned intensive care unit - stays). Radiotherapy within the year before adrenalectomy was significantly associated with higher 30-day major complication rates ( P =0.039). In the Eurocrine database, the proportion of laparoscopic procedures reached 85.3% without impairing resection completeness (R0: 92.9%). Factors associated with poor overall survival were the presence of extra-adrenal metastases (hazard ratio =0.64; P =0.031) and incomplete resection (≥R1; hazard ratio=0.41; P =0.015).</p><p><strong>Conclusions: </strong>The number of patients who can receive local treatment for adrenal metastases is rising, and adrenalectomy is more often minimally invasive and has a low morbidity rate. Subsequent research should evaluate which patients would benefit from adrenal surgery.</p>","PeriodicalId":8017,"journal":{"name":"Annals of surgery","volume":null,"pages":null},"PeriodicalIF":7.5000,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Survival and Prognostic Factors After Adrenalectomy for Secondary Malignancy: A Combined Analysis of a French University Center Registry (Eurocrine) of 307 Patients and a French Nationwide Study of 2515 Patients.\",\"authors\":\"Agathe Rémond, Camille Marciniak, Xavier Lenne, Vincent Chouraki, Mathilde Gobert, Gregory Baud, Laure Maillard, Damien Bouriez, Ellen Liekens, Gianluca Donatini, Claire Nominé-Criqui, Ambroise Ravenet, Nicolas Santucci, Paulina Kuczma, Nicolas Bouviez, Christophe Tresallet, Eric Mirallié, Sophie Deguelte, Laurent Brunaud, Carole Guerin, Caroline Gronnier, Jean-Christophe Lifante, Amélie Bruandet, Didier Theis, Alexis Cortot, Arnaud Scherpereel, Aghiles Hamroun, François Pattou, Robert Caiazzo\",\"doi\":\"10.1097/SLA.0000000000006479\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To provide a nationwide description of postoperative outcomes and analysis of prognostic factors following adrenalectomy for metastases.</p><p><strong>Background: </strong>Adrenal glands are a common site of metastases in many malignancies. Diagnosis of adrenal metastases is on the rise, leading to an increasing number of patient candidates for surgery without consensual management.</p><p><strong>Methods: </strong>We conducted a population-based study between January 2012 and December 2022 using the French National Health Data System (SNDS) and the Eurocrine registry (NCT03410394). The first database exhaustively covers all procedures carried out in France, while the second provides more clinical information on procedures and tumor characteristics, based on the experience of 11 specialized centers.</p><p><strong>Results: </strong>From the SNDS, we extracted 2515 patients who underwent adrenalectomy for secondary malignancy and 307 from the Eurocrine database. The most common primary malignancies were lung cancer (n=1203, 47.8%) and renal cancer (n=555, 22.1%). One-year survival was 84.3% (n=2120). Thirty-day mortality and morbidity rates were, respectively, 1.3% (n=32) and 29.9% (n=753, including planned intensive care unit - stays). Radiotherapy within the year before adrenalectomy was significantly associated with higher 30-day major complication rates ( P =0.039). In the Eurocrine database, the proportion of laparoscopic procedures reached 85.3% without impairing resection completeness (R0: 92.9%). Factors associated with poor overall survival were the presence of extra-adrenal metastases (hazard ratio =0.64; P =0.031) and incomplete resection (≥R1; hazard ratio=0.41; P =0.015).</p><p><strong>Conclusions: </strong>The number of patients who can receive local treatment for adrenal metastases is rising, and adrenalectomy is more often minimally invasive and has a low morbidity rate. Subsequent research should evaluate which patients would benefit from adrenal surgery.</p>\",\"PeriodicalId\":8017,\"journal\":{\"name\":\"Annals of surgery\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":7.5000,\"publicationDate\":\"2024-11-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Annals of surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/SLA.0000000000006479\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/8/7 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/SLA.0000000000006479","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/8/7 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"SURGERY","Score":null,"Total":0}
Survival and Prognostic Factors After Adrenalectomy for Secondary Malignancy: A Combined Analysis of a French University Center Registry (Eurocrine) of 307 Patients and a French Nationwide Study of 2515 Patients.
Objective: To provide a nationwide description of postoperative outcomes and analysis of prognostic factors following adrenalectomy for metastases.
Background: Adrenal glands are a common site of metastases in many malignancies. Diagnosis of adrenal metastases is on the rise, leading to an increasing number of patient candidates for surgery without consensual management.
Methods: We conducted a population-based study between January 2012 and December 2022 using the French National Health Data System (SNDS) and the Eurocrine registry (NCT03410394). The first database exhaustively covers all procedures carried out in France, while the second provides more clinical information on procedures and tumor characteristics, based on the experience of 11 specialized centers.
Results: From the SNDS, we extracted 2515 patients who underwent adrenalectomy for secondary malignancy and 307 from the Eurocrine database. The most common primary malignancies were lung cancer (n=1203, 47.8%) and renal cancer (n=555, 22.1%). One-year survival was 84.3% (n=2120). Thirty-day mortality and morbidity rates were, respectively, 1.3% (n=32) and 29.9% (n=753, including planned intensive care unit - stays). Radiotherapy within the year before adrenalectomy was significantly associated with higher 30-day major complication rates ( P =0.039). In the Eurocrine database, the proportion of laparoscopic procedures reached 85.3% without impairing resection completeness (R0: 92.9%). Factors associated with poor overall survival were the presence of extra-adrenal metastases (hazard ratio =0.64; P =0.031) and incomplete resection (≥R1; hazard ratio=0.41; P =0.015).
Conclusions: The number of patients who can receive local treatment for adrenal metastases is rising, and adrenalectomy is more often minimally invasive and has a low morbidity rate. Subsequent research should evaluate which patients would benefit from adrenal surgery.
期刊介绍：
The Annals of Surgery is a renowned surgery journal, recognized globally for its extensive scholarly references. It serves as a valuable resource for the international medical community by disseminating knowledge regarding important developments in surgical science and practice. Surgeons regularly turn to the Annals of Surgery to stay updated on innovative practices and techniques. The journal also offers special editorial features such as "Advances in Surgical Technique," offering timely coverage of ongoing clinical issues. Additionally, the journal publishes monthly review articles that address the latest concerns in surgical practice.
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