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Kutikov Leads International Effort to Optimize Management of Adrenal Masses

Alexander Kutikov, MD, FACS

 

Fox Chase Cancer Center’s Alexander Kutikov, MD, FACS, Chief of the Division of Urology and Urologic Oncology, is leading an international initiative to provide a point-of-care resource for the treatment of patients with adrenal masses. 

Adrenal masses are common and the majority of them will be benign, never creating a problem for the patient. However, about 10% of these adrenal masses can be problematic, Kutikov explained.

“These masses can produce hormones that make people sick and increase risk of stroke, heart attack, renal failure, and more,” he said. “Unfortunately, the workup and recommendations for the management of these masses is decentralized and fragmented.”

For example, there are at least eight existing guidelines on the management of adrenal incidentalomas, many of which recommend different approaches and are never updated. Some of the largest professional organizations representing surgeons do not have guidelines on the topic.

Adding to the complexity, many of the patients diagnosed with an adrenal mass are referred across a variety of specialties, including endocrinology, urology, or general surgery. Many of these specialists may only see one or two cases related to adrenal masses per year. This means these patients often receive inadequate care.

“At Fox Chase, our group has written the chapter for urologic surgery on this topic,” said Kutikov, who—together with Robert G. Uzzo, MD, MBA, FACS, Interim CEO of Fox Chase—has co-authored the definitive chapter on adrenal disorders in the latest edition of the Campbell-Walsh Urology textbook. “We comb through the literature on this topic regularly to make sure that chapter is updated.”

Now, the Society of Rare Genitourinary Tumors (GSRGT) has tapped Kutikov to create a free, centralized and up-to-date resource on adrenal masses: www.AdrenalMass.org. The goal of the website is to assist clinicians with the evaluation and treatment of adrenal masses. The website also includes patient handouts, perioperative instructions, and detailed instructions on how to do hormonal workups, which Kutikov said can be complex.

The website can be accessed on mobile devices or desktop computers and provides tabular and graphical summaries of guideline recommendations that clinicians can easily reference and execute in their clinical practice. 

In the future, Kutikov and the GSRGT hope to expand the website further and reach more key stakeholders. He also hopes to post information on adrenal mass clinical trials to provide an easy place for clinicians to send patients when trials are needed.