{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T10:52:53Z","timestamp":1779360773445,"version":"3.51.4"},"reference-count":34,"publisher":"Wiley","issue":"1-2","license":[{"start":{"date-parts":[[2024,11,14]],"date-time":"2024-11-14T00:00:00Z","timestamp":1731542400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Posterior retroperitoneoscopic adrenalectomy (PRA) for isolated adrenal metastasis is minimally invasive, may prolong survival and improve quality of life. The current evidence base is scant.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A multi\u2010site retrospective analysis of all cases of PRA for adrenal metastasis between 2011 and 2023, by four high\u2010volume adrenal surgeons was performed. Perioperative morbidity, disease\u2010free and survival outcomes were reported.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 51 patients, 34(67%) male, mean age 63\u2009\u00b1\u200912\u2009years, mean BMI 28; 49 PRAs for adrenal metastatectomy were completed (one abandoned due to tumour unresectability, one conversion to anterior laparoscopic approach) across 11 hospitals (49% public). Primary tumours included: 11 colorectal, 11 renal, 8 lung, 6 hepatocellular, 4 sarcoma, 3 breast, 2 melanoma, 2 ovarian and 1 each of pancreatic, oesophageal, testicular and prostate cancer. There were 12 synchronous (&lt;6\u2009months) and 39 metachronous (&gt;6\u2009months after primary diagnosis) tumours; 21 (42%) left sided, none bilateral. Mean operative time was 95\u2009\u00b1\u200934\u2009minutes, mean maximal tumour diameter was 34\u2009mm\u2009\u00b1\u200913\u2009mm and median length of hospitalization 1\u2009\u00b1\u20091\u2009days. There were 8 (16%) complications; 1 ICU admission, 1 re\u2010admission for pneumonia and 6 Clavien\u2010Dindo grade I complications. There were 10 (20%) mortalities and a median overall survival of 29\u2009months (range 7\u2013123, <jats:italic>n<\/jats:italic>\u2009=\u200941). Disease recurred in 15 (40%) patients (<jats:italic>n<\/jats:italic>\u2009=\u200937), with a median disease\u2010free interval of 18\u2009months (range 1\u201368). Port site recurrence occurred in 2 patients, both simultaneously with disseminated metastases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In carefully selected patients with adrenal metastases, PRA by high\u2010volume adrenal surgeons has minimal morbidity and short hospitalization. Surgery should be considered prior to local ablation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ans.19308","type":"journal-article","created":{"date-parts":[[2024,11,14]],"date-time":"2024-11-14T12:07:09Z","timestamp":1731586029000},"page":"84-90","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Posterior retroperitoneal adrenalectomy for metastatic disease: a multi\u2010site <scp>Australian<\/scp> series"],"prefix":"10.1111","volume":"95","author":[{"given":"Mark","family":"Fenton","sequence":"first","affiliation":[{"name":"Surgical Services John Hunter Hospital  New Lambton Heights New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4552-9579","authenticated-orcid":false,"given":"David","family":"Leong","sequence":"additional","affiliation":[{"name":"Endocrine Surgical Unit University of Sydney  St Leonards New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5029-0569","authenticated-orcid":false,"given":"Jessica","family":"Wong","sequence":"additional","affiliation":[{"name":"Endocrine Surgical Unit University of Sydney  St Leonards New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Zotov","sequence":"additional","affiliation":[{"name":"Department of Surgery Royal Melbourne Hospital  Parkville Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen","family":"Farrell","sequence":"additional","affiliation":[{"name":"Department of Surgery St. Vincent's Hospital  Fitzroy Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julie A","family":"Miller","sequence":"additional","affiliation":[{"name":"Department of Surgery Royal Melbourne Hospital  Parkville Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark S","family":"Sywak","sequence":"additional","affiliation":[{"name":"Endocrine Surgical Unit University of Sydney  St Leonards New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3122-8660","authenticated-orcid":false,"given":"Christine J","family":"O'Neill","sequence":"additional","affiliation":[{"name":"Surgical Services John Hunter Hospital  New Lambton Heights New South Wales Australia"},{"name":"School of Medicine and Public Health University of Newcastle  Newcastle New South Wales Australia"},{"name":"Surgical and Perioperative Care Research Program Hunter Medical Research Institute  Newcastle New South Wales Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,11,14]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000002749"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000003876"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2018.11.008"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-012-2352-0"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/jso.27267"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12020-015-0596-8"},{"key":"e_1_2_9_8_1","first-page":"1215","article-title":"Adrenalectomy for solid tumor metastases: results of a multicenter European study","volume":"154","author":"Moreno P","year":"2013","journal-title":"Surgery (United States)"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2021.04.037"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-023-13543-y"},{"key":"e_1_2_9_11_1","first-page":"1","article-title":"Outcomes after surgical treatment of metastatic disease in the adrenal gland; valuable for the patient?","volume":"14","author":"Metman MJH","year":"2022","journal-title":"Cancers (Basel)"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/ans.18443"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/ans.12508"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-020-05759-w"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-012-2553-4"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajco.13078"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000133083.54934.ae"},{"key":"e_1_2_9_18_1","first-page":"870","article-title":"American Association of Endocrine Surgeons Guidelines for Adrenalectomy","volume":"157","author":"Yip L","year":"2022","journal-title":"Execut. 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