Adrenokortikal Karsinom, Tek Merkez 5 Yıllık Deneyim

Year 2021, Volume: 2 Issue: 3, 190 - 193, 17.11.2021

Hayrettin Dizen Dursun Burak Özdemir Ahmet Karayiğit Bülent Ünal

Abstract

Giriş: Adrenokortikal kanser (AKK) nadir görülen bir kanser türüdür. Cerrahi rezeksiyon, AKK için bilinen tek küratif tedavi yöntemidir. Cerrahi tedavi sonrası %70’ e varan nüks oranları bildirilmiştir. Cerrahi sınır pozitifliği ve tümörün ekimi kötü prognostik faktörlerdir. Bu nedenle AKK cerrahisinin yüksek volümlü merkezlerde deneyimli cerrahlar tarafından yapılması önerilmektedir. Çalışmamızın amacı, nadir görülen bu hastalık grubundaki cerrahi deneyimimizi paylaşmaktır. Yöntemler: Osmangazi Üniversitesi Genel Cerrahi Kliniğinde Mart 2016-Mart 2021 tarihleri arasında AKK nedeniyle adrenalektomi uygulanan 8 hastanın verileri retrospektif olarak incelendi. Bulgular: Çalışmaya dahil edilen toplam 8 hastanın 5’ i kadın 3’ ü erkekti. AKK’ lerin 3’ ü (%37,5) sağ, 5’i (%62,5) sol adrenal bezde yerleşimli idi. Biyokimyasal incelemelerde 5 hastada (%62,5) fonksiyonel tümör saptandı. Hastalarımızın ortalama yaşı 45 (25-72) idi. Hastaların 5’ i (%62,5) açık cerrahi yöntemle 3’ ü (%37,5) ise laparoskopik yöntemle, transabdominal teknikle opere edildi. Lokal ileri evrede tanı alan 2 hastada sol böbreğe ve dalağa invazyon görüldü. Bu hastalara adrenalektomiye ek olarak nefrektomi ve splenektominin eklendiği en-blok rezeksiyonlar uygulandı. Perioperatif ve erken postoperatif dönemde hastaların hiçbirinde komplikasyon izlenmedi. Sonuç: AKK nadir görülen bir tümördür. Çoğu merkezde deneyim kısıtlıdır. Çok merkezli ve prospektif olarak dizayn edilecek çalışmalarla AKK’ de cerrahi tedavinin etkinliği ve sonuçları daha iyi şekilde analiz edilebilir.

Keywords

Adrenokortikal kanser, Adrenalektomi, Cerrahi

Adrenocortıc Carcınoma, Sıngle Center 5 Years Experıence

Abstract

Introduction: Adrenocortical cancer (ACC) is a rare cancer. Surgical resection is the only known curative treatment for ACC. Recurrence rates of up to 70% have been reported after surgical treatment. Surgical margin positivity was defined as poor prognostic factor. Therefore, it is recommended that ACC surgery be performed by experienced surgeons in high-volume centers. The aim of our study is to share our surgical experience in this rare disease group. Methods: The data of 8 patients who underwent adrenalectomy for ACC between March 2016 and March 2021 in the General Surgery Clinic of Osmangazi University were retrospectively analyzed. Results: Five of the patients were female and 3 were male. Three (37.5%) of the ACCs were located in the right adrenal gland, and 5 (62.5%) were located in the left adrenal gland. Biochemical examinations revealed functional tumors in 5 patients. The mean age of our patients was 45 (25-72). Five (62.5%) of the patients were operated with open surgery method and 3 (37.5%) patients were operated with laparoscopic transabdominal approach. Invasion to the left kidney and spleen was observed in 2 patients diagnosed at locally advanced stage. These patients underwent en-bloc resections with nephrectomy and splenectomy in addition to adrenalectomy. No complications were observed in any of the patients in the perioperative and early postoperative period. Conclusion: ACC is a rare tumor. Experience is limited in most centres. The efficacy and results of surgical treatment in ACC can be better analyzed with multicenter and prospective studies.

Keywords

Adrenocortical cancer, Adrenalectomy, Surgery

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