European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
August 13, 2026 · via Europe PMC
Robotic versus laparoscopic adrenalectomy for adrenocortical carcinoma: A national cancer database analysis.
Silvani C, Santangelo A, Considine J, +11 more, Abdollah F.
AI summary — for doctors, generated from the abstract only
In the NCDB, robotic adrenalectomy for localized adrenocortical carcinoma was associated with fewer positive margins, fewer open conversions and shorter stays than laparoscopy.
What was studied
National Cancer Database analysis of 657 patients with localized ACC undergoing planned minimally invasive adrenalectomy (413 laparoscopic, 244 robotic), 2010-2022.
Key findings
- Positive margins adjusted OR 0.60 (0.37-0.98)
- Conversion to open adjusted OR 0.54 (0.31-0.95)
- Stay >2 days adjusted OR 0.63 (0.43-0.93)
- No difference in 30-day readmission
Clinical relevance
This suggests robotic surgery may mitigate some perioperative challenges of MIS for ACC, though long-term oncologic outcomes were not assessed.
Who should care
Limitations
Retrospective registry analysis with possible selection bias; no survival or recurrence data.
Robotic surgery may give cleaner margins than laparoscopy for adrenal cancer.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
Introduction
The role of minimally invasive surgery (MIS) in adrenocortical carcinoma (ACC) remains debated due to concerns about oncologic safety. Robotic technology may overcome some limitations of laparoscopy, but comparative data specific to ACC are lacking. We aim to compare perioperative outcomes of robotic versus laparoscopic adrenalectomy for localized ACC.
Methods
We analyzed patients with localized ACC (2010-2022) from the National Cancer Database (NCDB) who underwent a planned minimally invasive adrenalectomy for ACC. This study evaluated 4 main endpoints: 1) positive surgical margins (PSM) 2) Intraoperative conversion to open 3) Length of stay after surgery (≤2 vs > 2 days); 4) 30-day unplanned hospital-readmission. Multivariable logistic regression clustered by facility was used to assess associations between surgical approach (laparoscopy vs robotic) and the outcomes.
Results
We included 657 patients, 413 laparoscopic vs 244 robotic. There were no significant differences in median tumor size, age, sex, or comorbidity distribution between groups. Robotic adrenalectomy was associated with lower odds of PSM (adjusted OR 0.60, 95% CI 0.37-0.98, p = 0.04) and conversion to open surgery (adjusted OR 0.54, 95% CI 0.31-0.95, p = 0.03). Robotic cases also showed a lower likelihood of prolonged hospitalization (>2 days) (adjusted OR 0.63, 95% CI 0.43-0.93, p = 0.02). No differences were observed in 30 days unplanned readmission.
Conclusions
Robotic adrenalectomy for ACC was associated with lower rates of positive margins, open conversion and prolonged hospitalization compared with laparoscopy. These findings suggest that robotic technology may mitigate some perioperative challenges of MIS in ACC, warranting further validation in prospective studies.
DOI
10.1016/j.ejso.2026.112068
PMID
42623815
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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