{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T14:02:37Z","timestamp":1787320957005,"version":"build-2736575974"},"reference-count":31,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2020,12,22]],"date-time":"2020-12-22T00:00:00Z","timestamp":1608595200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2020,12,22]],"date-time":"2020-12-22T00:00:00Z","timestamp":1608595200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,12,22]],"date-time":"2020-12-22T00:00:00Z","timestamp":1608595200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Projekt DEAL"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Extrahepatic manifestation of hepatocellular carcinoma (HCC) is rare and primarily affects lung, lymph nodes and bone. Metastases to the adrenal glands are relatively infrequent. This 25\u2010year institutional experience aimed for an analysis of factors influencing survival in patients undergoing surgery for HCC adrenal metastasis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective analysis of the institutional database of the Clinic for General\u2010, Visceral\u2010 and Transplantation Surgery of the University Medical Center Mainz, Germany, was performed. Patients who underwent surgery for HCC adrenal metastases from January 1995 to June 2020 were included. Pre\u2010, peri\u2010 and postoperative factors with potential influence on survival were assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In 16 patients (14\u00a0males, two females), one bilateral and 15 unilateral adrenalectomies were performed (13\u00a0metachronous, three synchronous). Thirteen operations were carried out via laparotomy, and three adrenalectomies were minimally invasive (two laparoscopic, one retroperitoneoscopic). Median overall survival (after HCC diagnosis) was 35\u00a0months, range: 5\u2013198. Median post\u2010resection survival (after adrenalectomy) was 15\u00a0months, range: 0\u201375. Overall survival was longer in patients with the primary HCC treatment being liver transplantation (median 66\u00a0months) or liver resection (median 51\u00a0months), compared to only palliative intended treatment of the primary with chemotherapy (median 35\u00a0months) or local ablation (median 23\u00a0months).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Surgery is a feasible treatment option for patients with adrenal metastases originating from HCC. In patients who underwent adrenalectomy for HCC adrenal metastasis, overall survival was superior, if primary HCC treatment was potentially curative (liver transplantation or resection).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00268-020-05909-0","type":"journal-article","created":{"date-parts":[[2020,12,22]],"date-time":"2020-12-22T15:02:26Z","timestamp":1608649346000},"page":"1118-1125","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Survival After Adrenalectomy for Metastatic Hepatocellular Carcinoma: A 25\u2010year Institutional Experience"],"prefix":"10.1002","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5538-5276","authenticated-orcid":false,"given":"JI.","family":"Staubitz","sequence":"first","affiliation":[{"name":"Section of Endocrine Surgery, Department of General, Visceral and Transplantation Surgery, University Medical Center Johannes Gutenberg\u2010University Mainz Langenbeckstra\u00dfe 1 55131 Mainz Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Hoppe\u2010Lotichius","sequence":"additional","affiliation":[{"name":"Department of General, Visceral and Transplantation Surgery University Medical Center Johannes Gutenberg\u2010University Mainz Mainz Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Baumgart","sequence":"additional","affiliation":[{"name":"Department of General, Visceral and Transplantation Surgery University Medical Center Johannes Gutenberg\u2010University Mainz Mainz Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Mittler","sequence":"additional","affiliation":[{"name":"Department of General, Visceral and Transplantation Surgery University Medical Center Johannes Gutenberg\u2010University Mainz Mainz Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"Lang","sequence":"additional","affiliation":[{"name":"Department of General, Visceral and Transplantation Surgery University Medical Center Johannes Gutenberg\u2010University Mainz Mainz Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"TJ.","family":"Musholt","sequence":"additional","affiliation":[{"name":"Section of Endocrine Surgery, Department of General, Visceral and Transplantation Surgery, University Medical Center Johannes Gutenberg\u2010University Mainz Langenbeckstra\u00dfe 1 55131 Mainz Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,12,22]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2013.06.021"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010012\u20101506\u20103"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.4158\/EP.15.S1.1"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00423\u2010011\u20100889\u20101"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00423\u2010019\u201001768\u2010z"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00423\u2010015\u20101293\u2010z"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/1477\u20107819\u20103\u201050"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12262\u2010017\u20101680\u20105"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40792\u2010019\u20100705\u20107"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1159\/000446245"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/jso.20773"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1478\u20103231.2008.01864.x"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.25960"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.3892\/mco.2014.259"},{"key":"e_1_2_8_16_1","first-page":"4195076","article-title":"adrenal 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The local ethical committee approved the present study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Human or animal rights"}},{"value":"Additional informed consent was obtained from all individual participants for whom identifying information is included in this article.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}