{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T09:14:06Z","timestamp":1776417246821,"version":"3.51.2"},"reference-count":15,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T00:00:00Z","timestamp":1774569600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Local and peritoneal recurrence (L\/PR) after curative surgery for adrenocortical carcinoma has a high incidence and negatively affects the clinical course of the disease. We retrospectively reviewed our database to investigate the role of regional surgery and prophylactic HIPEC on oncologic outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Fifty-eight patients with stage II and III adrenocortical carcinoma (ACC) who underwent curative surgery were grouped according to the therapeutic approach: 11 received regional adrenalectomy and HIPEC (REGHIPEC), 18 underwent regional adrenalectomy (REGIONAL), and 29 had simple adrenalectomy (SIMPLE). The primary outcome was local\/peritoneal disease-free survival (L\/PDFS); secondary outcomes included overall disease-free survival (ODFS) and disease-specific survival (DSS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>HIPEC increased surgery duration by 80\u2005minutes and hospital stay by 3 days. Major morbidity was 27.2% in the REGHIPEC group and 5.5% in the REGIONAL group. Median post-operative follow-up was 56 months for the entire cohort. L\/PR was observed in 0%, 35%, and 82% of cases in the study groups, respectively. REGHIPEC and REGIONAL groups did not reach the median L\/PDFS, while the SIMPLE group had a median L\/PDFS of 23 months (P &amp;lt; .001). Overall recurrence (including hematogenous metastases) was observed in 18%, 50%, and 86.2% of cases, respectively (P &amp;lt; .001). Disease-specific mortality during follow-up was 18%, 33%, and 72.4% in the three groups, respectively. REGHIPEC and REGIONAL groups did not reach the median DSS, while the SIMPLE group had a median DSS of 63 months (P = .014).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>HIPEC after regional adrenalectomy has decreases the incidence of local and peritoneal recurrence. If confirmed, this therapeutic strategy may change the surgical approach to stage II-III ACC.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ejendo\/lvag057","type":"journal-article","created":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T12:50:54Z","timestamp":1774529454000},"page":"482-488","source":"Crossref","is-referenced-by-count":0,"title":["Regional adrenalectomy completed by prophylactic hyperthermic intraperitoneal chemotherapy reduces the incidence of local and peritoneal recurrence after curative surgery for adrenocortical carcinoma"],"prefix":"10.1093","volume":"194","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7635-1179","authenticated-orcid":false,"given":"Guido Alberto Massimo","family":"Tiberio","sequence":"first","affiliation":[{"name":"General Surgery, Department of Clinical and Experimental Sciences. University of Brescia at ASST Spedali Civili di Brescia , Brescia 25123 ,","place":["ITALY"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giovanni","family":"Casole","sequence":"additional","affiliation":[{"name":"General Surgery, Department of Clinical and Experimental Sciences. University of Brescia at ASST Spedali Civili di Brescia , Brescia 25123 ,","place":["ITALY"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Deborah","family":"Cosentini","sequence":"additional","affiliation":[{"name":"Medical Oncology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia at ASST Spedali Civili di Brescia , Brescia 25123 ,","place":["ITALY"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8457-122X","authenticated-orcid":false,"given":"Marta","family":"Lagan\u00e0","sequence":"additional","affiliation":[{"name":"Medical Oncology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia at ASST Spedali Civili di Brescia , Brescia 25123 ,","place":["ITALY"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandra","family":"Sigala","sequence":"additional","affiliation":[{"name":"Section of Pharmacology, Department of Molecular and Translational Medicine, University of Brescia , Brescia 25123 ,","place":["ITALY"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Silvia","family":"Ministrini","sequence":"additional","affiliation":[{"name":"General Surgery, Department of Clinical and Experimental Sciences. University of Brescia at ASST Spedali Civili di Brescia , Brescia 25123 ,","place":["ITALY"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alfredo","family":"Berruti","sequence":"additional","affiliation":[{"name":"Medical Oncology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia at ASST Spedali Civili di Brescia , Brescia 25123 ,","place":["ITALY"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2026,3,27]]},"reference":[{"issue":"4","key":"2026041704192801400_lvag057-B1","doi-asserted-by":"publisher","first-page":"G1","DOI":"10.1530\/EJE-18-0608","article-title":"European Society of Endocrinology clinical practice guidelines on the management of adrenocortical carcinoma in adults, in collaboration with the European Network for the Study of Adrenal Tumors","volume":"179","author":"Fassnacht","year":"2018","journal-title":"Eur J Endocrinol."},{"issue":"11","key":"2026041704192801400_lvag057-B2","doi-asserted-by":"publisher","first-page":"1476","DOI":"10.1016\/j.annonc.2020.08.2099","article-title":"Adrenocortical carcinomas and malignant phaeochromocytomas: ESMO\u2013EURACAN clinical practice guidelines for diagnosis, treatment and follow-up","volume":"31","author":"Fassnacht","year":"2020","journal-title":"Ann Oncol."},{"issue":"7","key":"2026041704192801400_lvag057-B3","doi-asserted-by":"publisher","first-page":"839","DOI":"10.6004\/jnccn.2021.0032","article-title":"Neuroendocrine and adrenal tumors, version 2.2021, NCCN clinical practice guidelines in oncology","volume":"19","author":"Shah","year":"2021","journal-title":"J Natl Compr Canc Netw."},{"issue":"4","key":"2026041704192801400_lvag057-B4","doi-asserted-by":"publisher","first-page":"358","DOI":"10.1002\/bjs.10414","article-title":"European Society of Endocrine Surgeons (ESES) and European Network for the Study of Adrenal Tumours (ENSAT) recommendations for the surgical management of adrenocortical carcinoma","volume":"104","author":"Gaujoux","year":"2017","journal-title":"Br J Surg."},{"issue":"1","key":"2026041704192801400_lvag057-B5","doi-asserted-by":"publisher","first-page":"186","DOI":"10.1016\/j.surg.2018.04.068","article-title":"Longitudinal patterns of recurrence in patients with adrenocortical carcinoma","volume":"165","author":"Glenn","year":"2019","journal-title":"Surgery"},{"issue":"5","key":"2026041704192801400_lvag057-B6","doi-asserted-by":"publisher","first-page":"493","DOI":"10.1111\/iju.15678","article-title":"Comparison between minimally invasive surgery and open surgery in managing localized adrenocortical carcinoma treatment: a retrospective propensity-matched study","volume":"32","author":"Zhao","year":"2025","journal-title":"Int J Urol."},{"issue":"1","key":"2026041704192801400_lvag057-B7","doi-asserted-by":"publisher","first-page":"118","DOI":"10.1093\/ejendo\/lvad002","article-title":"The management of postoperative disease recurrence in patients with adrenocortical carcinoma: a retrospective study in 106 patients","volume":"188","author":"Calabrese","year":"2023","journal-title":"Eur J Endocrinol."},{"issue":"January 2013","key":"2026041704192801400_lvag057-B8","doi-asserted-by":"publisher","first-page":"207","DOI":"10.1210\/jc.2012","article-title":"The role of surgery in the management of recurrent adrenocortical carcinoma","volume":"98","author":"Erdogan","year":"2017","journal-title":"Jpn J Clin Oncol"},{"issue":"2","key":"2026041704192801400_lvag057-B9","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1515\/pp-2021-0152","article-title":"Update of randomized controlled trials evaluating cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) in prevention and therapy of peritoneal metastasis: a systematic review","volume":"7","author":"Noiret","year":"2022","journal-title":"Pleura Peritoneum"},{"key":"2026041704192801400_lvag057-B10","doi-asserted-by":"publisher","first-page":"383","DOI":"10.1016\/j.jss.2018.06.012","article-title":"A phase II trial of cytoreduction and hyperthermic intraperitoneal chemotherapy for recurrent adrenocortical carcinoma","volume":"232","author":"Hughes","year":"2018","journal-title":"J Surg Res."},{"issue":"4","key":"2026041704192801400_lvag057-B11","doi-asserted-by":"publisher","first-page":"969","DOI":"10.3390\/cancers12040969","article-title":"Hyperthermic intraperitoneal chemotherapy for primary or recurrent adrenocortical carcinoma. 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