Our Summary

The research paper discusses adrenocortical carcinoma (ACC), a rare and deadly cancer that affects the adrenal glands. The best chance for patients to be cured is through complete surgical removal of the tumor, but often the cancer comes back even after successful surgery. This underlines the need for highly skilled surgeons and careful surgical methods. The paper also talks about minimally invasive surgery (MIS) - a type of surgery that uses small cuts instead of large incisions. MIS is commonly used for removing smaller, non-cancerous adrenal tumors. However, there’s debate about whether it should be used for ACC. This paper reviews scientific literature to compare the outcomes of traditional “open” surgery and MIS for treating ACC.

FAQs

  1. What is adrenocortical carcinoma (ACC) and how is it typically treated?
  2. What is minimally invasive surgery (MIS) and how is it used in treating adrenal tumors?
  3. Is there a consensus in the medical community about using MIS for treating ACC?

Doctor’s Tip

A doctor might tell a patient that minimally invasive surgery can offer many benefits, such as smaller incisions, less pain, shorter recovery time, and reduced risk of complications compared to traditional open surgery. They may also explain that MIS may not be suitable for all cases, particularly for more complex or advanced cancers like adrenocortical carcinoma. It’s important for patients to discuss with their healthcare team to determine the best surgical approach for their specific situation.

Suitable For

Patients who are typically recommended for minimally invasive surgery include those with smaller, non-cancerous adrenal tumors that can be safely removed using this less invasive approach. Patients who are considered to be good candidates for MIS are typically in overall good health and do not have any contraindications to undergoing minimally invasive surgery. Additionally, patients who may benefit from a quicker recovery time, shorter hospital stay, and reduced risk of complications may also be recommended for minimally invasive surgery.

Timeline

Before minimally invasive surgery:

  1. Patient is diagnosed with adrenocortical carcinoma (ACC) through imaging tests, blood tests, and biopsy.
  2. Patient undergoes consultations with oncologists and surgeons to discuss treatment options.
  3. Patient undergoes pre-operative tests and evaluations to ensure they are fit for surgery.
  4. Patient may receive chemotherapy or radiation therapy before surgery to shrink the tumor.

During minimally invasive surgery:

  1. Surgeon makes small incisions in the abdomen to access the adrenal gland.
  2. Surgeon uses a laparoscope and specialized surgical instruments to remove the tumor.
  3. Surgery typically takes a few hours to complete.
  4. Patient is monitored closely in the recovery room before being transferred to a hospital room.

After minimally invasive surgery:

  1. Patient may experience some pain and discomfort at the incision sites.
  2. Patient is encouraged to walk and move around to aid in recovery.
  3. Patient may need to stay in the hospital for a few days for observation.
  4. Patient follows up with their surgeon and oncologist for post-operative care and monitoring.
  5. Patient may need further treatment such as chemotherapy or radiation therapy depending on the stage and aggressiveness of the cancer.

What to Ask Your Doctor

  1. What are the potential benefits of minimally invasive surgery compared to traditional open surgery for treating adrenocortical carcinoma?
  2. What are the potential risks or complications associated with minimally invasive surgery for adrenocortical carcinoma?
  3. How experienced is the surgical team in performing minimally invasive surgery for adrenocortical carcinoma?
  4. What is the success rate of minimally invasive surgery in treating adrenocortical carcinoma compared to traditional open surgery?
  5. How long is the recovery time typically for minimally invasive surgery for adrenocortical carcinoma?
  6. Are there any specific factors that make a patient a better candidate for minimally invasive surgery over traditional open surgery for adrenocortical carcinoma?
  7. How will my follow-up care and monitoring be different if I undergo minimally invasive surgery for adrenocortical carcinoma?
  8. Are there any long-term effects or considerations to keep in mind with minimally invasive surgery for adrenocortical carcinoma?
  9. Can you provide me with information or resources to further educate myself on minimally invasive surgery for adrenocortical carcinoma?
  10. Are there any clinical trials or advancements in minimally invasive surgery for adrenocortical carcinoma that I should be aware of?

Reference

Authors: Winoker JS, Ahlborn DT, Omidele OO, Fernandez-Ranvier G, Derweesh IH, Mehrazin R. Journal: Future Oncol. 2018 Feb;14(3):267-276. doi: 10.2217/fon-2017-0420. Epub 2018 Jan 18. PMID: 29345155