281P - Adrenal Tumor and Its Successful Management; a Chinese Experience & Report

Date 17 December 2016
Event ESMO Asia 2016 Congress
Session Poster lunch
Topics Endocrine Cancers
Presenter KIRAN JANG Kunwar
Authors K.J. Kunwar, P. Adhikari, Z. Fuqing
  • Urology, Wuhan Union Hospital (of Tongji Medical College of HUST), 430022 - Wuhan/CN

Abstract

Background

With the advancement in imaging modalities, Adrenal tumor is commonly encountered in outpatient clinic. The treatment for benign tumor, small size tumor can be defrrered with close follow up but big size tumor due to it being higher chance of adrenocortical carcinoma & clinically troublesome pheochromocytoma needs the definite surgical treatment. Minimally Invasive adrenalectomy has definetly an adge over other modalities of treatment. Therefore this study summarize the outcome of surgical treatment for adrenal tumor

Methods

A restrospective study was done those underwent adrenalectmy [Open(Group-I) and laparoscopic(Group-II) along with 1 year follow up. The main area of focus was surgical outcome, complications, patients status after 1 year post treatment. The following parameters were also evaluated; size, operative time, blood loss, analgesics, oral intake, mobilization & hospital stay. Comparable findings were tabled.

Results

A total of 125 adrenalectomy (Open & Laparoscopic) was successfully completed with the average tumor size: Group-I: 4.5cm (3-10) and Group-II: 3.2cm (2-8), Duration of the operation (112 ± 28 min vs 87.1±21 min, p<0.01), Blood loss (100.8.8±31 ml vs 43±24 ml, p< 0.01), Analgesics (5.32±0.49 vs 3.16±0.5 days, p<0.01), Ambulation (1.54±0.54 vs 1.1±0.30 days, p<0.01), Oral intake (2.1±0.60 vs 1.08±0.57 days, p<0.01), Hospital stay: (8.3±2.8 vs 4.6 ± 1.04 days, p<0.01).
On one year follow up, CT scan revealed no recurrence of tumor and no mortality is reported.

GROUP-(I)
open Adrenalectomy

GROUP- (II)
Minimally Invasive

P VALUE

PATIENTS (n)

25

100

AGE (Mean)

45.2

39.06

SIZE

4.5cm(3-10)

3.2cm(2-8)

OPERATION TIME

112 ± 28

87.1 ± 21

p<0.01

BLOOD LOSS

100.8 ± 31

43 ± 24

p<0.01

ORAL-INTAKE

2.1 ± 0.60

1.08 ± 0.57

p<0.01

ANELGESICS

5.32 ± 0.49

3.16 ± 0.5

p<0.01

AMBULATION

3.54 ± 0.78

1.1 ± 0.30

p<0.01

HOSPITAL STAY

8.3 ± 2.8

4.6 ± 1.24

p<0.01

Conclusions

Proper pre-operative workout to make an uneventful per-operative and post-operative period is the basic foundation for successful adrenalectomy. With experience hemorrhage can be minimized, Hemodynamic instability can be tackled and the big size of the tumor is not a contraindication for the selection of the laparoscopic approach. Thus, Minimally Invasive adrenalectomy is safe , effective and can be termed as the GOLD STANDARD in the treatment of adrenal tumor.

Clinical trial indentification