AI Article Synopsis
- Adrenocortical carcinoma (ACC) is a rare cancer, and this study investigates how lymph node dissection impacts patient prognosis and survival following surgery intended to cure the disease.
- Out of 897 patients, only 147 had their lymph nodes examined, with larger tumors and specific surgical settings increasing the likelihood of examination; however, finding lymph node metastasis did not correlate with improved survival rates.
- While lymph node examination itself didn’t enhance survival, the presence of positive lymph nodes indicated more advanced disease, suggesting that staging might still provide valuable prognostic insights.
Article Abstract
Background: Adrenocortical carcinoma (ACC) is a rare tumor and the role of lymph node dissection remains ill-defined. This study evaluates the effect of nodal examination on prognosis and survival in patients undergoing curative-intent resection of ACC.
Methods: The National Cancer Database (2004-2015) was queried for patients undergoing margin-negative resection for ACC. Patients with distant metastases, neoadjuvant therapy, multivisceral resection and T4 tumors were excluded.
Results: Among 897 patients, 147 (16.4%) had lymph nodes examined. Factors associated with lymph node examination included increasing tumor size (P < .001), extra-adrenal extension (P < .001), open operation (P < .001), and resection at an academic facility (P = .003). Lymph node metastasis was significantly associated with extra-adrenal tumor extension (P = .04). Lymph node harvest, regardless of the number of nodes examined, was not associated with a survival benefit. Median overall survival was incrementally worse with increasing number of positive lymph nodes (88.2 months for N0, 34.9 months for 1-3 positive nodes, and 15.6 months for ≥4 positive nodes, P < .001).
Conclusions: Lymph node harvest and lymph node metastasis were associated with more advanced tumors. Although nodal harvest did not offer a survival advantage, stratifying the nodal staging classification may provide important prognostic information.
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| http://dx.doi.org/10.1002/jso.26138 | DOI Listing |
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