The University of Southampton
University of Southampton Institutional Repository

Outcomes of surgery for benign and malignant adrenal disease from the British Association of Endocrine and Thyroid Surgeons' national registry

Outcomes of surgery for benign and malignant adrenal disease from the British Association of Endocrine and Thyroid Surgeons' national registry
Outcomes of surgery for benign and malignant adrenal disease from the British Association of Endocrine and Thyroid Surgeons' national registry

Background: This study investigated the indications, procedures and outcomes for adrenal surgery from the UK Registry of Endocrine and Thyroid Surgery database from 2005 to 2017, and compared outcomes between benign and malignant disease. Methods: Data on adrenalectomies were extracted from a national surgeon-reported registry. Preoperative diagnosis, surgical technique, length of hospital stay, morbidity and in-hospital mortality were examined. Results: Some 3994 adrenalectomies were registered among patients with a median age of 54 (i.q.r. 43–65) years (55·9 per cent female). Surgery was performed for benign disease in 81·5 per cent. Tumour size was significantly greater in malignant disease: 60 (i.q.r. 34–100) versus 40 (24–55) mm (P < 0·001). A minimally invasive approach was employed in 90·2 per cent of operations for benign disease and 48·2 per cent for cancer (P < 0·001). The conversion rate was 3·5-fold higher in malignant disease (17·3 versus 4·7 per cent; P < 0·001). The length of hospital stay was 3 (i.q.r. 2–5) days for benign disease and 5 (3–8) days for malignant disease (P < 0·050). In multivariable analysis, risk factors for morbidity were malignant disease (odds ratio (OR) 1·69, 1·22 to 2·36; P = 0·002), tumour size larger than 60 mm (OR 1·43, 1·04 to 1·98; P = 0·028) and conversion to open surgery (OR 3·48, 2·16 to 5·61; P < 0·001). The in-hospital mortality rate was below 0·5 per cent overall, but significantly higher in the setting of malignant disease (1·2 versus 0·2 per cent; P < 0·001). Malignant disease (OR 4·88, 1·17 to 20·34; P = 0·029) and tumour size (OR 7·47, 1·52 to 39·61; P = 0·014) were independently associated with mortality in multivariable analysis. Conclusion: Adrenalectomy is a safe procedure but the higher incidence of open surgery for malignant disease appears to influence postoperative outcomes.

0007-1323
1495-1503
Patel, N.
dff6db13-6b8a-47f9-8df9-f0b6553dd590
Egan, R. J.
8202cbef-023e-4315-9a60-8664cd2b28d1
Carter, B. R.
77429b65-5de1-460d-8d33-650c0e2bdfd0
Scott-Coombes, D. M.
8f516c15-36bb-4b4e-bd85-c93d9f1ca6c5
Stechman, M. J.
ca3aa76c-6175-457f-a17e-e3eb59b730a9
Afzaal, A.
d42f03c4-8183-41e7-9180-6be95ecc9479
Akhtar, I.
7bea4a24-baea-4f5a-a028-4d852e50f642
Akyol, M.
e9586d3c-165e-4c8e-a79a-5748c9a19ef2
Anderson, I.
456af0bd-3457-4496-add5-bc37ad2ee2c9
Aspinall, S.
9832f404-7334-4bca-bc68-85eac7d2466d
Balasubramanian, S.
1a2fed86-6085-43f7-a601-805b48144b4c
Banga, N.
b5a5ecef-ace3-44dd-88bb-faf25438a57f
Bliss, R.
6966892a-8264-4226-98de-7ee5b5091557
Brindle, R.
cfabdbbd-39c7-4b3f-8417-3090689b58eb
Carpenter, R.
c405e618-1967-409a-8ee2-f074f12a3780
Cave-Bigley, D.
e0dbf0ba-a085-4f64-9f03-5eebb8bac5a2
Chadwick, D.
2eb68efd-67d4-42e1-9299-145433de8ab2
Collins, R.
52f612a4-696b-4d61-a6ad-02a327c14e32
Craig, W.
c38bb8c3-a84b-4b85-9328-bce05266c5ed
Cvasciuc, T.
c47d337f-0458-4900-9c0f-39ad402f90a5
Doran, H.
1846a1be-bfa8-4ff5-820b-062f1a46343f
Dunn, J.
c8598b37-40c1-4177-9152-750bb4faed36
Eatock, F.
aa6526d1-795e-4dcd-b6c3-af05529e4f82
El-Saify, W.
d179f260-4e6d-4c03-a919-5f1b8240c424
Evans, A.
a8067d4a-c8b3-4278-a348-6fa0220bbfec
Galata, G.
17580503-f2ed-4556-8233-efc2fb297f18
Greaney, M. G.
ee2f7a53-a294-428a-8d91-ee0fbf7f7acb
Guy, A.
8bd221eb-7a43-4329-a60f-85bc04b65e9a
Hardy, R.
0bff6a58-43c9-46c4-8a2d-f0c1f9b550b4
Harrison, B.
20236f0e-6088-4032-95cc-1874f25b5987
Houghton, A.
b87006e2-948e-4ec3-8720-8053d11a7587
Hubbard, A.
caf9e178-ce26-42f4-8f29-bf1d5082cc1d
Jeddy, T.
ef62d965-9f97-4ebc-8a27-cab4643fa4d7
Kirkby-Bott, J.
4282d0e5-a493-4679-9659-d375a9f4f6a1
Krukowski, Z.
e01f4896-0346-4cd7-83ee-8925b6c16fb2
Kurup, V.
96aae3ce-fcfe-41e6-aa9f-d53564ca0935
Kurzawinski, T.
d1ccbfd0-3cf8-4b4a-b867-e6e91095002f
Lansdown, M.
44db98a5-8fdd-43d2-91d1-38ea9c84a770
Lennard, T. M.J.
2c72cbfa-9a12-4770-a3b3-a38538cfce07
Lim, B.
5bea9f70-4088-4ace-8b11-81b20a922f08
Maddox, P.
83a04285-1c9d-4828-b0f9-51dec4e272ed
Nicholson, M.
b0f25953-704e-442d-8e50-800b3b38d25e
Rew, D.
36dcc3ad-2379-4b61-a468-5c623d796887
Sharma, A.
4f53eb6b-5887-4623-a4cd-9786a98353be
Smith, D.
9ddd2301-9b64-4d08-a912-3faae3fc2c9a
Thomas, M.
033d92af-42b3-44d2-a572-c0dd3a33de3e
Thomas, P.
aaf05c89-52c7-4202-8d01-fb5cc52e4f9e
Tomlinson, M.
bdf178f4-1cf0-4e17-b8ed-b6b3f0b2da50
Williams, S.
762dd529-2acb-40b8-acf3-e3488eec8506
on behalf of the British Association of Endocrine and Thyroid Surgeons
Patel, N.
dff6db13-6b8a-47f9-8df9-f0b6553dd590
Egan, R. J.
8202cbef-023e-4315-9a60-8664cd2b28d1
Carter, B. R.
77429b65-5de1-460d-8d33-650c0e2bdfd0
Scott-Coombes, D. M.
8f516c15-36bb-4b4e-bd85-c93d9f1ca6c5
Stechman, M. J.
ca3aa76c-6175-457f-a17e-e3eb59b730a9
Afzaal, A.
d42f03c4-8183-41e7-9180-6be95ecc9479
Akhtar, I.
7bea4a24-baea-4f5a-a028-4d852e50f642
Akyol, M.
e9586d3c-165e-4c8e-a79a-5748c9a19ef2
Anderson, I.
456af0bd-3457-4496-add5-bc37ad2ee2c9
Aspinall, S.
9832f404-7334-4bca-bc68-85eac7d2466d
Balasubramanian, S.
1a2fed86-6085-43f7-a601-805b48144b4c
Banga, N.
b5a5ecef-ace3-44dd-88bb-faf25438a57f
Bliss, R.
6966892a-8264-4226-98de-7ee5b5091557
Brindle, R.
cfabdbbd-39c7-4b3f-8417-3090689b58eb
Carpenter, R.
c405e618-1967-409a-8ee2-f074f12a3780
Cave-Bigley, D.
e0dbf0ba-a085-4f64-9f03-5eebb8bac5a2
Chadwick, D.
2eb68efd-67d4-42e1-9299-145433de8ab2
Collins, R.
52f612a4-696b-4d61-a6ad-02a327c14e32
Craig, W.
c38bb8c3-a84b-4b85-9328-bce05266c5ed
Cvasciuc, T.
c47d337f-0458-4900-9c0f-39ad402f90a5
Doran, H.
1846a1be-bfa8-4ff5-820b-062f1a46343f
Dunn, J.
c8598b37-40c1-4177-9152-750bb4faed36
Eatock, F.
aa6526d1-795e-4dcd-b6c3-af05529e4f82
El-Saify, W.
d179f260-4e6d-4c03-a919-5f1b8240c424
Evans, A.
a8067d4a-c8b3-4278-a348-6fa0220bbfec
Galata, G.
17580503-f2ed-4556-8233-efc2fb297f18
Greaney, M. G.
ee2f7a53-a294-428a-8d91-ee0fbf7f7acb
Guy, A.
8bd221eb-7a43-4329-a60f-85bc04b65e9a
Hardy, R.
0bff6a58-43c9-46c4-8a2d-f0c1f9b550b4
Harrison, B.
20236f0e-6088-4032-95cc-1874f25b5987
Houghton, A.
b87006e2-948e-4ec3-8720-8053d11a7587
Hubbard, A.
caf9e178-ce26-42f4-8f29-bf1d5082cc1d
Jeddy, T.
ef62d965-9f97-4ebc-8a27-cab4643fa4d7
Kirkby-Bott, J.
4282d0e5-a493-4679-9659-d375a9f4f6a1
Krukowski, Z.
e01f4896-0346-4cd7-83ee-8925b6c16fb2
Kurup, V.
96aae3ce-fcfe-41e6-aa9f-d53564ca0935
Kurzawinski, T.
d1ccbfd0-3cf8-4b4a-b867-e6e91095002f
Lansdown, M.
44db98a5-8fdd-43d2-91d1-38ea9c84a770
Lennard, T. M.J.
2c72cbfa-9a12-4770-a3b3-a38538cfce07
Lim, B.
5bea9f70-4088-4ace-8b11-81b20a922f08
Maddox, P.
83a04285-1c9d-4828-b0f9-51dec4e272ed
Nicholson, M.
b0f25953-704e-442d-8e50-800b3b38d25e
Rew, D.
36dcc3ad-2379-4b61-a468-5c623d796887
Sharma, A.
4f53eb6b-5887-4623-a4cd-9786a98353be
Smith, D.
9ddd2301-9b64-4d08-a912-3faae3fc2c9a
Thomas, M.
033d92af-42b3-44d2-a572-c0dd3a33de3e
Thomas, P.
aaf05c89-52c7-4202-8d01-fb5cc52e4f9e
Tomlinson, M.
bdf178f4-1cf0-4e17-b8ed-b6b3f0b2da50
Williams, S.
762dd529-2acb-40b8-acf3-e3488eec8506

Patel, N., Egan, R. J., Carter, B. R., Scott-Coombes, D. M. and Stechman, M. J. , on behalf of the British Association of Endocrine and Thyroid Surgeons (2019) Outcomes of surgery for benign and malignant adrenal disease from the British Association of Endocrine and Thyroid Surgeons' national registry. British Journal of Surgery, 106 (11), 1495-1503. (doi:10.1002/bjs.11297).

Record type: Article

Abstract

Background: This study investigated the indications, procedures and outcomes for adrenal surgery from the UK Registry of Endocrine and Thyroid Surgery database from 2005 to 2017, and compared outcomes between benign and malignant disease. Methods: Data on adrenalectomies were extracted from a national surgeon-reported registry. Preoperative diagnosis, surgical technique, length of hospital stay, morbidity and in-hospital mortality were examined. Results: Some 3994 adrenalectomies were registered among patients with a median age of 54 (i.q.r. 43–65) years (55·9 per cent female). Surgery was performed for benign disease in 81·5 per cent. Tumour size was significantly greater in malignant disease: 60 (i.q.r. 34–100) versus 40 (24–55) mm (P < 0·001). A minimally invasive approach was employed in 90·2 per cent of operations for benign disease and 48·2 per cent for cancer (P < 0·001). The conversion rate was 3·5-fold higher in malignant disease (17·3 versus 4·7 per cent; P < 0·001). The length of hospital stay was 3 (i.q.r. 2–5) days for benign disease and 5 (3–8) days for malignant disease (P < 0·050). In multivariable analysis, risk factors for morbidity were malignant disease (odds ratio (OR) 1·69, 1·22 to 2·36; P = 0·002), tumour size larger than 60 mm (OR 1·43, 1·04 to 1·98; P = 0·028) and conversion to open surgery (OR 3·48, 2·16 to 5·61; P < 0·001). The in-hospital mortality rate was below 0·5 per cent overall, but significantly higher in the setting of malignant disease (1·2 versus 0·2 per cent; P < 0·001). Malignant disease (OR 4·88, 1·17 to 20·34; P = 0·029) and tumour size (OR 7·47, 1·52 to 39·61; P = 0·014) were independently associated with mortality in multivariable analysis. Conclusion: Adrenalectomy is a safe procedure but the higher incidence of open surgery for malignant disease appears to influence postoperative outcomes.

This record has no associated files available for download.

More information

Published date: 1 October 2019
Additional Information: Funding Information: The authors acknowledge all contributing members of BAETS and Dendrite Clinical Systems. Disclosure: The authors declare no conflict of interest. Publisher Copyright: © 2019 BJS Society Ltd Published by John Wiley & Sons Ltd

Identifiers

Local EPrints ID: 447940
URI: http://eprints.soton.ac.uk/id/eprint/447940
ISSN: 0007-1323
PURE UUID: 5188f183-6374-47f9-bc26-20d1abc16c06
ORCID for D. Rew: ORCID iD orcid.org/0000-0002-4518-2667

Catalogue record

Date deposited: 26 Mar 2021 17:31
Last modified: 18 Mar 2024 03:52

Export record

Altmetrics

Contributors

Author: N. Patel
Author: R. J. Egan
Author: B. R. Carter
Author: D. M. Scott-Coombes
Author: M. J. Stechman
Author: A. Afzaal
Author: I. Akhtar
Author: M. Akyol
Author: I. Anderson
Author: S. Aspinall
Author: S. Balasubramanian
Author: N. Banga
Author: R. Bliss
Author: R. Brindle
Author: R. Carpenter
Author: D. Cave-Bigley
Author: D. Chadwick
Author: R. Collins
Author: W. Craig
Author: T. Cvasciuc
Author: H. Doran
Author: J. Dunn
Author: F. Eatock
Author: W. El-Saify
Author: A. Evans
Author: G. Galata
Author: M. G. Greaney
Author: A. Guy
Author: R. Hardy
Author: B. Harrison
Author: A. Houghton
Author: A. Hubbard
Author: T. Jeddy
Author: J. Kirkby-Bott
Author: Z. Krukowski
Author: V. Kurup
Author: T. Kurzawinski
Author: M. Lansdown
Author: T. M.J. Lennard
Author: B. Lim
Author: P. Maddox
Author: M. Nicholson
Author: D. Rew ORCID iD
Author: A. Sharma
Author: D. Smith
Author: M. Thomas
Author: P. Thomas
Author: M. Tomlinson
Author: S. Williams
Corporate Author: on behalf of the British Association of Endocrine and Thyroid Surgeons

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×