Perioperative Residual Adrenal Function After Extended Resection for Retroperitoneal Soft Tissue Sarcomas

Evaluation of Perioperative Residual Adrenal Function After Extended Multivisceral Resection for Primary Retroperitoneal Soft Tissue Sarcomas: a Prospective Observational Study

Early recognition of adrenal function deficit in patients undergoing multivisceral surgery including adrenalectomy for primitive retroperitoneal sarcomas

The extended multivisceral resection of retroperitoneum is the standard treatment for primary retroperitoneal soft tissue sarcomas. This procedure also includes the removal of the healthy adrenal gland ipsilateral to the tumor site.

The investigators think that a such extended surgical approach together with the removal of the adrenal gland may lead to a state of acute adrenal insufficiency and related hemodynamic instability.

In order to recognize this condition the investigators use a low dose ACTH test (Synacthen test) during the 1° and 10° post-operative days.

Inclusion Criteria:

• Adult patients (age> 18 years)
• Diagnosis of retroperitoneal sarcoma
• Adrenalectomy enbloc included in multivisceral resection
• Voluntary informed written consent

Exclusion Criteria:

• Recurrent and / or metastatic disease
• Patient chronically treated with corticosteroids
• Primary disorders of adrenal gland
• Basal serum cortisol values ≤ 7 µg / dL
• Clinically significant heart disease
• Altered TSH