European Society of Endocrine Surgeons (ESES) and European Network for the Study of Adrenal Tumours (ENSAT) recommendations for the surgical management of adrenocortical carcinoma

• DOI: 10.1002/bjs.10414
• Publication Date: 2017-02-15T13:35:30Z
• Authors: S Gaujoux; R Mihai; B Carnaille; B Dousset; C Fiori; F Porpiglia; P Hellman; M Iacobone; J-L Kraimps; G Donatini; J Langenhuijsen; K Lorenz; M Mathonnet; E Mirallié; C Blanchard; E Nieveen van Dijkum; M Raffaelli; N Rayes; F Sébag; F Triponez; A Valeri; J Waldmann; F Zinzindohoue
• Keywords: Aftercare; Medical Records; Neoplasms, Multiple Primary; 03 medical and health sciences; 0302 clinical medicine; Preoperative Care; Adrenocortical Carcinoma; Humans; Neoplasm Metastasis; Medical History Taking; Physical Examination; Referral and Consultation; 2. Zero hunger; Palliative Care; Adrenalectomy; Neoplasms, Second Primary; Cytoreduction Surgical Procedures; Adrenal Cortex Neoplasms; Adrenal Cortex Neoplasms; Adrenalectomy; Adrenocortical Carcinoma; Aftercare; Cytoreduction Surgical Procedures; Humans; Lymph Node Excision; Lymphatic Metastasis; Medical History Taking; Medical Records; Neoplasm Metastasis; Neoplasm Recurrence, Local; Neoplasms, Multiple Primary; Neoplasms, Second Primary; Organ Sparing Treatments; Palliative Care; Physical Examination; Positron-Emission Tomography; Preoperative Care; Referral and Consultation; Tomography, X-Ray Computed; Surgery; 3. Good health; Lymphatic Metastasis; Positron-Emission Tomography; Adrenal Cortex Neoplasms; Adrenalectomy; Adrenocortical Carcinoma; Aftercare; Cytoreduction Surgical Procedures; Humans; Lymph Node Excision; Lymphatic Metastasis; Medical History Taking; Medical Records; Neoplasm Metastasis; Neoplasm Recurrence, Local; Neoplasms, Multiple Primary; Neoplasms, Second Primary; Organ Sparing Treatments; Palliative Care; Physical Examination; Positron-Emission Tomography; Preoperative Care; Referral and Consultation; Tomography, X-Ray Computed; Lymph Node Excision; Neoplasm Recurrence, Local; Organ Sparing Treatments

Abstract

Background Radical surgery provides the best chance of cure for adrenocortical carcinoma (ACC), but perioperative surgical care for these patients is yet to be standardized.

Methods A working group appointed jointly by ENSAT and ESES used Delphi methodology to produce evidence-based recommendations for the perioperative surgical care of patients with ACC. Papers were retrieved from electronic databases. Evidence and recommendations were classified according to the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system, and were discussed until consensus was reached within the group.

Results Twenty-five recommendations for the perioperative surgical care of patients with ACC were formulated. The quality of evidence is low owing to the rarity of the disease and the lack of prospective surgical trials. Multi-institutional prospective cohort studies and prospective RCTs are urgently needed and should be strongly encouraged.

Conclusion The present evidence-based recommendations provide comprehensive advice on the optimal perioperative care for patients undergoing surgery for ACC.