Universität zu Köln

Chiapponi, Costanza, Dos Santos, Daniel Pinto, Hartmann, Milan Janis Michael, Schmidt, Matthias, Faust, Michael, Wahba, Roger, Bruns, Christiane Josephine, Schultheis, Anne Maria and Alakus, Hakan (2022). Adrenal Surgery in the Era of Multidisciplinary Endocrine Tumor Boards. Horm. Metab. Res., 54 (5). S. 294 - 300. STUTTGART: GEORG THIEME VERLAG KG. ISSN 1439-4286

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Abstract

Work up of adrenal masses includes assessment of endocrine activity and malignancy risk. There is no indication for surgical removal of nonfunctional adrenal adenomas, according to the guidelines. In the present study, we aimed at evaluating the impact of a university endocrine tumor board on the quality of the indications for adrenal surgery at our institution. One hundred consecutive patients receiving primary adrenal surgery at the University Hospital of Cologne, Germany were included. Their demographics, clinic-pathologic characteristics, treatment and outcome were analyzed. In 55 (55%) cases, indication for surgery consisted in functional benign tumors, including Conn, Cushing adenomas and pheochromocytomas. Forty (40%) tumors were referred to surgery for malignancy suspicion and 5 (5%) myelolipomas were removed due to their size. Eighty-nine percent of surgeries were performed as minimally invasive procedures. Overall morbidity included two (2%) self-limiting pancreatic fistulas after left laparoscopic adrenalectomy for pheochromocytoma. All functional tumors were confirmed benign by final histology. Only 33 (82.5%) of 40 suspicious cases turned out to be malignant. Consequently, nonfunctional benign adenomas were unnecessarily removed in only 7 (7%) patients, with 6 (85.7%) of them having a history of extra-adrenal cancer and all of them fulfilling criteria for surgery, according to the international guidelines. In conclusion, the endocrine tumor board provided an excellent adherence to the guidelines with most surgeries being performed either for functional or malignant tumors. In nonfunctional tumors with history of extra adrenal cancer, CT guided biopsy might be considered for obviating surgery.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Chiapponi, Costanza UNSPECIFIED UNSPECIFIED UNSPECIFIED Dos Santos, Daniel Pinto UNSPECIFIED UNSPECIFIED UNSPECIFIED Hartmann, Milan Janis Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Schmidt, Matthias UNSPECIFIED UNSPECIFIED UNSPECIFIED Faust, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Wahba, Roger UNSPECIFIED UNSPECIFIED UNSPECIFIED Bruns, Christiane Josephine UNSPECIFIED UNSPECIFIED UNSPECIFIED Schultheis, Anne Maria UNSPECIFIED UNSPECIFIED UNSPECIFIED Alakus, Hakan UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-668477
DOI:	10.1055/a-1808-7239
Journal or Publication Title:	Horm. Metab. Res.
Volume:	54
Number:	5
Page Range:	S. 294 - 300
Date:	2022
Publisher:	GEORG THIEME VERLAG KG
Place of Publication:	STUTTGART
ISSN:	1439-4286
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language Endocrinology & Metabolism Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/66847