Neoplasms

Gland and Hormone Related Diseases

All Conditions

Adrenal Gland Neoplasms

Endocrine Gland Neoplasms

Adrenal Gland Diseases

Endocrine System Diseases

Vasoconstrictor Agents

Respiratory System Agents

All Drugs and Chemicals

Epinephrine

Racepinephrine

Epinephryl borate

Needlescopic instruments, defined as those with a diameter of no more than 3 mm. They result in smaller incisions than conventional 5- to 12-mm instruments.

needlescopic adrenalectomy and laparoscopic adrenalectomy

Chun-Hou Liao, MD

Shih-Chieh Chueh, MD. PhD

The study is a prospective radonmized comparison between needlescopic adrenalectomy and conventional laparoscopic adrenalectomy for benign adrenal tumors less than 5 cm. The operative success rate, operative time, intraoperative blood loss, intraoperative or postoperative complication, postoperative pain, postoperative hospital stay, convalescence, and wound cosmesis were compared.

Needlescopic instruments, defined as those with a diameter of no more than 3 mm. They result in smaller incisions than conventional 5- to 12-mm instruments, and thus better cosmesis. It may further reduce postoperative pain, hospital stay, and recovery time.

All operations were performed with the lateral transperitoneal approach. A 12-mm port was created near the umbilicus for a 30-degree telescope, and another two(for left lesions) or three (for right lesions) 2-mm working ports (Tyco Healthcare, Norwalk, Connecticut, USA) were created along the ipsilateral subcostal region. Careful dissection was done with the use of a 2-mm hook or scissors electrocoagulator. The adrenal vein of the lesion side was isolated and controlled with a 2-mm mini-bipolar coagulation apparatus (Tyco Healthcare) for a long segment. The vein was then transected closer to the adrenal gland, leaving the coagulated stump at the renal vein or vena cava as long as possible, even when a short right adrenal vein was encountered. Then the adrenal gland with the tumor was dissected from its surrounding tissues after several tiny vessels were transected with the needlescopic instruments mentioned above. The specimen was put into a retrieval bag and removed through the umbilical port.

Prospective Randonmized Comparison of Needlescopic Versus Conventional Laparoscopic Adrenalectomy

Prospective Randonmized Comparison of Needlescopic Versus Conventional Laparoscopic Adrenalectomy for Benign Adrenal Tumors Less Than 5 cm in Diameter

National Taiwan University Hospital

Shih-Chieh Chueh

Diseases and Abnormalities at or Before Birth

Congenital Abnormalities

Anti-Inflammatory Agents

Antineoplastic Agents

Antiemetics

Gastrointestinal Agents

Pharmaceutical Solutions

Anti-Infective Agents

Central Nervous System Depressants

Micronutrients

Dexamethasone

Dexamethasone acetate

Ethanol

Radiopharmaceuticals

Iodine

Adrenergic Agents

Adrenergic alpha-Agonists

Adrenergic Agonists

Neurotransmitter Agents

Adrenergic beta-Agonists

Bronchodilator Agents

Anti-Asthmatic Agents

Mydriatics

Sympathomimetics

The patient will be given 5 drops of saturated solution of potassium iodide daily for 2 days prior to the study and will continue for 5 to 7 days later to minimize the radiation dose to the thyroid gland. One to 2 mCi of I 131 1,6-beta-iodomethyl-19-norcholesterol (NP-59) in 10% ethanol, 0.23% polysorbate 80 and 0.9% NaCl will be given intravenously slowly over 1-5 minutes. Anterior and posterior images of the adrenal area will be obtained 72 and 96 hours later. Additional images will be made if indicated. Each image would require 30 minutes carried out in the nuclear medicine laboratory. To verify the exact location of the adrenal glands, renal scan with 99m Tc DTPA or Mag 3 (routine nuclear medicine radiopharmaceuticals) will also be obtained whenever indicated. In some patients, dexamethasone suppression will be carried out to improve the specificity of NP 59 diagnosis for autonomous hormonal secretions by the adrenal tumors.

Imaging, Adrenal acans

One to 2 mCi of I 131 1,6-beta-iodomethyl-19-norcholesterol (NP-59) in 10% ethanol, 0.23% polysorbate 80 and 0.9% NaCl will be given intravenously slowly over 1-5 minutes.

(NP-59)

Neeta Pandit-Taskar, MD

The purpose of this study is to find out if your adrenal glands are normal or abnormal. This can be determined by whether or not your adrenal gland concentrates more of a labeled building block of adrenal hormone, norcholesterol. This labeled material had been used as an investigative diagnostic tool for imaging adrenal glands for many years with success in our hands. This is a diagnostic procedure. CT, MRI and Ultrasound can determine the size and presence or absence of tumor but cannot assess the function of the adrenal glands. To determine hormone concentrations from blood samples would involve more invasive catherization.

To investigate the feasibility of using NP-59 to localize adrenal tumors and assess their functions under the influence of pharmacological manipulations.

Adrenal Scans With Radioiodine-Labeled Norcholesterol (NP-59)

Memorial Sloan Kettering Cancer Center

Fluorodeoxyglucose F18

FDG-PET scan

DAVID TAEB

This is a prospective study which aims to validate a new diagnostic approach in the tissue characterization of adrenal tumors indeterminate on conventional imaging. For this purpose, it is not necessary to have a control group since the diagnostic accuracy in a well defined subset of patients.

Visit 0 : Enrollment, eligibility. Visit 1 : FDG-PET. Visit 2 : Postoperative visit. Visit 3 : 6 months post-PET. Visit 4 : 12 months post-PET.

Primary objective The primary objective is to assess the diagnostic accuracy of FDG-PET, particularly the SUVmax tumor/liver ratio, in the diagnosis of indeterminate adrenal tumors on conventional imaging.

Secondary objectives

* To assess the diagnostic accuracy of the tumor SUVmax, and SUVmax of the tumor/mean SUV of the liver.
* To evaluate the relationship between SUVmax tumor/liver ratio and Weiss score.
* To evaluate the impact of the use of FDG-PET on the treatment options.
* To evaluate the economic impact of FDG-PET in the management of indeterminate adrenal tumors (ancillary study).

Performance of 18F-Fluorodeoxyglucose Positron Emission Tomography (FDG-PET) in the Diagnosis of Indeterminate Adrenal Tumors on Conventional Imaging: A French Prospective Multicentric Study

Assistance Publique Hopitaux De Marseille

Hormones

Patients who wll receive adrenal RF ablation.

Patients who will receive abdominal radiofrequency ablation other than adrenal gland.

Radiofrequency (RF) ablation was done after RF electrodes were placed in the adrenal tumor in the adrenal RF ablation group. RF ablation was done after RF electrodes were placed in the targeted abdominal tumors other than adrenal gland in the abdominal RF ablation other than adrenal gland group.

Radiofrequency ablation

Koichiro Yamakado, MD

The purpose of this study is to evaluate changes in adrenal hormones during adrenal radiofrequency (RF) ablation.

Adrenal radiofrequency (RF) ablation has been increasingly used for the treatment of unresectable adrenal tumors. But one of the major complication is a increase in blood pressure. Hormonal release during RF ablation is considered the cause of hypertension. But there has been no evidence that adrenal hormones affects changes in blood pressure. In this prospective study, we evaluate the changes in adrenal hormones during RF ablation and clarify the cause of hypertensive crisis.

Changes in Adrenal Hormones During Adrenal Radiofrequency Ablation

Blood pressure was monitored during radiofrequency (RF) ablation. The frequency of hypertension (systolic blood pressure of more than 200 mmHg) was evaluated and compared between the adrenal and non-adrenal (RF ablation other than adrenal gland) RF ablation groups.

Mie University

Clinical Professor

Patients who received adrenal radiofrequency (RF) ablation.

Adrenal Radiofrequency Ablation

Patients who received radiofrequency (RF) ablation other than adrenal gland such as liver and kidney.

Abdominal Radiofrequency Ablation Other Than Adrenal Gland

Total

Age, Categorical

Age, Continuous

Sex: Female, Male

Japan

Region of Enrollment

Small patient series is one of limitations of this study

Dr. Koichiro Yamakado

Increase in Catecholamine

Increase in Cortisol

Serum Cathecholamine Levels

Number of Participants With Hypertension During Adrenal or Non-adrenal Radiofrequency Ablation

Overall Study

Rare Diseases

Adrenal Cancer

Operations are done with an high definition 3D laparoscopic system (Olympus, Tokyo, Japan); all personnel wear polarized glasses to achieve stereoscopic imaging in the operating room. Dissection is realized using a hybrid energy system (Thunderbeat, Olympus Europe Se \& Co, Hamburg, Germany).

José Ignacio Rodríguez-Hermosa, MD, PhD

The main drawbacks of conventional 2D laparoscopy are limited depth perception and loss of spatial orientation. High-quality 3D laparoscopy systems might improve surgical outcomes for adrenalectomy.

Over recent decades, technological advances such as improved video imaging (high-definition cameras), better instrumentation for dissection and hemostasis, articulating staplers, and optimized operating room lighting have added safety, efficacy, and precision to minimally invasive procedures. However, until recently, laparoscopy required surgeons to operate in a three-dimensional (3D) space with only two-dimensional (2D) images to guide their movements, resulting in a lack of depth perception and loss of spatial orientation that increased the risk of errors, fatigue, operative time, and operating room stress and made the technique difficult to learn.

High-quality 3D laparoscopy was developed as an alternative to conventional 2D laparoscopy. Several clinical trials and observational studies have compared surgical outcomes between 2D and 3D laparoscopic systems; however, few clinical studies have examined the usefulness of 3D laparoscopy systems for adrenalectomies.

3D Laparoscopic Adrenalectomies for Adrenal Tumors

Three-dimensional Laparoscopic Adrenalectomies for Benign and Malignant Adrenal Tumors

Rate of medical and surgical complications within 30 days after surgery using the Dindo-Clavien classification, described as:

Grade I = Any deviation from the normal postoperative course. Grade 2 = Requiring pharmacological treatment with drugs other than such allowed for grade I complications.

Grade III = Requiring surgical, endoscopic or radiological intervention, not under (Grade IIIa) or under general anesthesia (Grade IIIb) Grade IV = Life-threatening complication with single organ (Grade IVa) or Multiorgan dysfunction (Grade IVb) Grade V = Death of a patient.

Total length of hospital stay will be recorded in days beginning at admission for surgery until discharge (number of days) .

Use of abdominal drainage intraoperatively (Yes vs No).

ASA I A normal healthy patient ASA II A patient with mild systemic disease ASA III A patient with severe systemic disease ASA IV A patient with severe systemic disease that is a constant threat to life ASA V A moribund patient who is not expected to survive without the operation ASA VI A declared brain-dead patient whose organs are being removed for donor purposes

Adrenal mass \<6 cm, Adrenal mass ≥6 cm

Incidentaloma, Aldosteronoma, Pheochromocytoma, Cushing's Adenoma and malignant adrenal tumors (primary or metastasis)

Conversion (Yes vs No), operative time (min), bleeding (ml), Clavien-Dindo Classification

Institut d'Investigació Biomèdica de Girona Dr. Josep Trueta

MD, PhD

Symptoms and General Pathology

Carcinoma

Syndrome

Cushing Syndrome

Pheochromocytoma

Carcinogenesis

Adrenocortical Carcinoma

Cell Transformation, Neoplastic

Hyperaldosteronism

Paraganglioma

Neuroendocrine Tumors

Neuroectodermal Tumors

Neuroectodermal Tumors, Primitive

Neoplasms, Germ Cell and Embryonal

Neoplasms by Histologic Type

Neoplasms, Nerve Tissue

Adrenocortical Hyperfunction

Adenocarcinoma

Neoplasms, Glandular and Epithelial

Adrenal Cortex Neoplasms

Adrenal Cortex Diseases

Cushing's Syndrome

Paragangliomas 1

Neuroendocrine Tumor

Neuroepithelioma

Hyperadrenalism

Tumor material and corresponding biosamples from patients with adrenal tumors

Biomaterial from patients without adrenal tumor

Martin Fassnacht, MD

Stefanie Hahner, MD

The pathogenesis of adrenal tumors is still not fully elucidated and the treatment options for malignant tumors are poor. The current study investigates different aspects of the pathogenesis of adrenal tumors and evaluates different therapeutic options in patients with adrenocortical carcinoma.

Germline DNA Tumor samples Serum Plasma Urine

Adrenal Tumors - Pathogenesis and Therapy

Investigation of the Tumorigenesis of Adrenal Tumors and Evaluation of New Therapeutic Options - Untersuchungen Zur Tumorgenese Von Nebennierentumoren Und Evaluation Neuer Therapieoptionen

Deutsche Krebshilfe e.V., Bonn (Germany)

German Federal Ministry of Education and Research

University of Wuerzburg

Head of Endocrinology

Anesthetics

Harald Groeben, Prof., M.D.

Harald Groeben, Prof, M.D.

This study is a prospective, perioperative evaluation of hemodynamic and respiratory parameters in patients undergoing retroperitoneoscopic adrenalectomies.

Due to their underlying disease, patients with adrenal tumors are prone to episodes of hyper- and hypotension. Furthermore, excessive hypercarbia and an increased arterial-alveolar CO2 difference can be seen during these operations.

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
Prospective Randonmized Comparison of Needlescopic Versus Conventional Laparoscopic Adrenalectomy	NCT00713115	Adrenal Tumors	needlescopic ad...	3 Years - 80 Years	National Taiwan University Hospital
Adrenal Scans With Radioiodine-Labeled Norcholesterol (NP-59)	NCT00591643	Adrenal Tumors Adrenal Maligna... Abnormal Hormon... Electrolytes Ab...	Imaging, Adrena... (NP-59)	-	Memorial Sloan Kettering Cancer Center
Performance of 18F-Fluorodeoxyglucose Positron Emission Tomography (FDG-PET) in the Diagnosis of Indeterminate Adrenal Tumors on Conventional Imaging: A French Prospective Multicentric Study	NCT01284829	Adrenal Tumors	FDG-PET scan	18 Years -	Assistance Publique Hopitaux De Marseille
Changes in Adrenal Hormones During Adrenal Radiofrequency Ablation	NCT00997594	Adrenal Tumors	Radiofrequency ...	20 Years -	Mie University
Performance of 18F-Fluorodeoxyglucose Positron Emission Tomography (FDG-PET) in the Diagnosis of Indeterminate Adrenal Tumors on Conventional Imaging: A French Prospective Multicentric Study	NCT01284829	Adrenal Tumors	FDG-PET scan	18 Years -	Assistance Publique Hopitaux De Marseille
3D Laparoscopic Adrenalectomies for Adrenal Tumors	NCT04905706	Adrenal Tumor Adrenalectomy; ...		18 Years -	Institut d'Investigació Biomèdica de Girona Dr. Josep Trueta
Adrenal Scans With Radioiodine-Labeled Norcholesterol (NP-59)	NCT00591643	Adrenal Tumors Adrenal Maligna... Abnormal Hormon... Electrolytes Ab...	Imaging, Adrena... (NP-59)	-	Memorial Sloan Kettering Cancer Center
Adrenal Tumors - Pathogenesis and Therapy	NCT00669266	Adrenal Tumors Adrenocortical ... Cushing Syndrom... Conn Syndrome Pheochromocytom...		- 100 Years	University of Wuerzburg
Changes in Adrenal Hormones During Adrenal Radiofrequency Ablation	NCT00997594	Adrenal Tumors	Radiofrequency ...	20 Years -	Mie University
3D Laparoscopic Adrenalectomies for Adrenal Tumors	NCT04905706	Adrenal Tumor Adrenalectomy; ...		18 Years -	Institut d'Investigació Biomèdica de Girona Dr. Josep Trueta
Anesthesia Management of Retroperitoneal Adrenalectomies	NCT00894335	Adrenal Tumors		18 Years - 90 Years	Kliniken Essen-Mitte

Spots Global Cancer Trial Database for adrenal tumors