{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T11:15:07Z","timestamp":1761822907033},"reference-count":30,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2006,4,17]],"date-time":"2006-04-17T00:00:00Z","timestamp":1145232000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2006,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Laparoscopic adrenalectomy (LA) is the procedure of choice for small benign adrenal tumors. In the absence of local invasion or metastases, the preoperative diagnosis of an adrenocortical carcinoma (ACC) is difficult, often leaving size as the principal predictor of malignancy. Large tumors are resectable laparoscopically, but the long\u2010term outcome and therefore appropriateness of LA for cortical tumors &gt; 6\u00a0cm is not known.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We reviewed the LA experience in our institution since its introduction in June 1994. Patients who underwent LA for solid cortical tumors \u2265 60\u00a0mm in diameter without preoperative or intraoperative evidence of malignancy were reviewed. Follow\u2010up data, including clinical examination, biochemical analysis, and repeat scans, were reviewed for evidence of local or systemic recurrent disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Between 1994 and 2004 a total of 462 adrenalectomies were performed, 391 of which were done laparoscopically. Among them, 19 were solid cortical tumors \u2265 60\u00a0mm in diameter with no overt malignant preoperative or intraoperative characteristics: 9\u00a0nonsecreting tumors, 8 Cushing\u2019s syndrome tumors (including 2 virilizing variants), 1 virilizing tumor, and 1 aldosteronoma. The mean age of the patients was 49.9 years (range 22\u201377 years), and the mean tumor size was 69.0\u00a0mm (range 60\u201380\u00a0mm). Histology confirmed a cortical adenoma in eight patients, malignant tumors in three, and indeterminate tumors in eight. The mean follow\u2010up was 34\u00a0months (range 4\u2013108\u00a0months). Two patients died of systemic recurrent disease (liver metastases) at 10 and 19\u00a0months, respectively, following surgery; two other patients died 12 and 21\u00a0months, respectively following surgery owing to unrelated cardiovascular and cerebrovascular pathology. One patient underwent surgery for local recurrence 54\u00a0months after primary surgery; the remaining 14 patients are well with no clinical or radiologic evidence of recurrent disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Laparoscopic adrenalectomy for large solid cortical tumors without pre\u2010 or intraoperative evidence of malignancy is not contraindicated, and it is unlikely to have a deleterious effect on long\u2010term outcome. Each case should be considered individually. We provide an algorithm for the approach to adrenocortical tumors \u2265 6\u00a0cm.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-005-0288-2","type":"journal-article","created":{"date-parts":[[2006,4,19]],"date-time":"2006-04-19T07:40:10Z","timestamp":1145432410000},"page":"893-898","source":"Crossref","is-referenced-by-count":57,"title":["Long\u2010term Outcome following Laparoscopic Adrenalectomy for Large Solid Adrenal Cortex Tumors"],"prefix":"10.1002","volume":"30","author":[{"given":"F. 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