Table 1.
Demographic and baseline characteristics.
| Characteristic | Total (N=305) | <6 cm (n=261) | ≥6 cm (n=44) | P value |
|---|---|---|---|---|
| Male sex – no. (%) | 168 (55) | 140 (54) | 28 (64) | 0.22 |
| Age – yr (range) | 63 (25-87) | 64 (27-87) | 56.5 (25-84) | 0.09 |
| Mode of discovery – no. (%) | ||||
| Incidental | 27 (9) | 24 (91) | 3 (7) | <.0001 |
| Cancer staging | 27 (9) | 24 (91) | 3 (7) | |
| Mass effect symptoms | 14 (5) | 0 | 14 (32) | |
| Location – no. (%) | ||||
| Right | 141 (44) | 110 (41) | 31 (59) | 0.02 |
| Left | 180 (56) | 158 (59) | 22 (42) | |
| Unilateral | 289 (95) | 254 (97) | 35 (80) | <.0001 |
| Bilateral | 16 (5) | 7/261 (3) | 9 (20) | |
| Congenital adrenal hyperplasia – no. (%) | 2 (0.7) | 1 (0.4) | 1 (2.3) | 0.15 |
| Hemorrhage – no. (%) | 9 (3) | 3 (1) | 6 (14) | <.0001 |
| Initial size (range) – cm | 2.3 (0.5-18.0) | 2.0 (0.5-5.8) | 8.5 (6.0-18.0) | <.0001 |
| Final size (range) – cm | 2.6 (0.5-19.3) | 2.5 (0.5-17.0) | 7.9 (6.0-19.3) | <.0001 |
| Hormonal workup – no. (%) | 126 (41) | 94/261 (36) | 32/44 (73) | <.0001 |
| Autonomous cortisol secretion | 3/92 (3) | 3/66 (5) | 0/26 (0) | 0.27 |
| Primary aldosteronism | 9/74 (12) | 8/58 (14) | 1/16 (6) | 0.41 |
| Pheochromocytoma | 0/96 (0) | 0/71 (0) | 0/25 (0) | -- |
| Adrenalectomy – no. (%) | 37 (12) | 14 (5) | 23 (52) | <.0001 |
| Laparoscopic | 21 (57) | 11 (79) | 10 (44) | 0.04 |
| Open | 15 (40) | 3 (21) | 12 (52) | 0.07 |
| Laparoscopic → open | 1 (3) | 0 (0) | x1 (4) | -- |
| Indication for surgery – no. (%) | ||||
| Large tumor size/tumor growth | 12 (32) | 5 (36) | 7 (31) | |
| Diagnostic surgery | 10 (27) | 4 (29) | 6 (26) | |
| Mass effect symptoms | 5 (14) | 1 (7) | 4 (17) | |
| Concomitant ipsilateral tumor w/ hormonal excessa | 4 (11) | 3 (21) | 1 (4) | |
| Acute hemorrhage | 3 (8) | 0 (0) | 3 (13) | |
| Concomitant resection during non-adrenal surgeryb | 3 (8) | 1 (7) | 2 (9) | |
a
Two patients had autonomous cortisol secretion due to adrenal adenoma and 2 patients had primary aldosteronism due to adrenal adenoma.
b
One patient underwent bilateral adrenalectomy for definitive management of persistent Cushing disease after unsuccessful pituitary resection and 2 patients underwent adrenalectomy during resection of ipsilateral renal carcinoma.