Tabbara MM, Gonzalez J, Ciancio G. Re: Olivero A, et al. Adrenocortical carcinoma with venous tumor invasion: is there a role for mini-invasive surgery?
Langenbecks Arch Surg 2023;
408:87. [PMID:
36780100 PMCID:
PMC9925599 DOI:
10.1007/s00423-023-02827-2]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 01/29/2023] [Indexed: 02/14/2023]
Abstract
PURPOSE
The surgical treatment for adrenocortical carcinoma with venous tumor invasion remains a challenge for surgeons. A critical factor in determining the surgical approach is utilizing a classification system that accurately defines the tumor thrombus level.
METHODS
Olivero and colleagues report their experience regarding the feasibility of mini-invasive surgery for adrenocortical carcinoma with venous tumor invasion. They studied the outcome of 20 patients from 4 international referral center databases.
RESULTS
They describe a classification for adrenal tumor with tumor thrombus into four levels: (1) adrenal vein invasion; (2) renal vein invasion; (3) infra-hepatic inferior vena cava (IVC); and (4) retro-hepatic IVC.
CONCLUSIONS
We congratulate the authors for their work and patient outcomes; however, in efforts to avoid confusion in the surgical community, we believe their classification system requires modification compared to our classification system developed in 2004.
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