Clinical Outcomes and Predictive Factors in Adrenalectomy: A Retrospective Cohort Study

Background & Objective: Adrenal tumors present a notable prevalence of ۴-۷% in individuals above ۴۰ years old. Current guidelines recommend adrenalectomy for hormone-secreting, potentially malignant, or large (>۴ cm) lesions. However, the outcomes of adrenalectomy and their clinical-pathological associations remain poorly defined. This study assessed adrenalectomy outcomes and explored its clinical, demographic, and pathologic correlates.Methods: In this retrospective cohort study, the medical records of all patients who underwent adrenalectomy from March ۲۰۱۶ to March ۲۰۲۱ at a referral center in Tehran were reviewed. Also, a clinical follow-up via telephone was conducted. The chi-square test, independent t-test, and analysis of variance were utilized for statistical analysis.Results: Data from a total of ۷۵ patients (۵۵ females) were reviewed. The mean age of the participants was ۴۲.۶۷ years. Of them, ۶۰%, ۲۲.۷%, ۱۴.۷%, and ۱.۳% had pheochromocytoma, Cushing's syndrome, Conn's syndrome, and insulinoma, respectively. Malignancy was associated with greater tumor size (p<۰.۰۰۰) and mitotic rate (p=۰.۰۴۶), and the presence of necrosis (p=۰.۰۰۱), and capsular and vascular invasion (p<۰.۰۰۰). Clinical follow-up visits of ۴۵ patients indicated ۸۴.۴% showed a complete response to the treatment (surgical ± medical). Treatment response was significantly influenced by approach (laparoscopic favored; p=۰.۰۰۱), surgery duration (<۱۵۰ minutes better; p=۰.۰۱۷), mass pathology (adenoma favored; p=۰.۰۳۴), and capsular invasion (absence better; p=۰.۰۱۲).Conclusion: Adrenalectomy outcomes were significantly affected by surgical approach and tumor pathology, notably capsular invasion. Larger studies are needed to determine the predictive values of clinical and pathologic variables in adrenalectomy for adrenal tumors.

کلیدواژه ها:

Adrenal Tumor ، Adrenalectomy ، Aldosteronism ، Cushing ، hypertension ، Pheochromocytoma