Moreno P, de la Quintana Basarrate A, Musholt TJ, Paunovic I, Puccini M, Vidal O, Ortega J, Kraimps JL, Bollo Arocena E, Rodríguez JM, González López O, Del Pozo CD, Iacobone M, Veloso E, Del Pino JM, García Sanz I, Scott-Coombes D, Villar-Del-Moral J, Rodríguez JI, Vázquez Echarri J, González Sánchez C, Gutiérrez Rodríguez MT, Escoresca I, Nuño Vázquez-Garza J, Tobalina Aguirrezábal E, Martín J, Candel Arenas MF, Lorenz K, Martos JM, Ramia JM. Adrenalectomy for solid tumor metastases: results of a multicenter European study.
Surgery 2013;
154:1215-22; discussion 1222-3. [PMID:
24238044 DOI:
10.1016/j.surg.2013.06.021]
[Citation(s) in RCA: 66] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2013] [Accepted: 06/21/2013] [Indexed: 02/07/2023]
Abstract
BACKGROUND
We assessed the results of adrenalectomy for solid tumor metastases in 317 patients recruited from 30 European centers.
METHODS
Patients with histologically proven adrenal metastatic disease and undergoing complete removal(s) of the affected gland(s) were eligible.
RESULTS
Non-small cell lung cancer (NSCLC) was the most frequent tumor type followed by colorectal and renal cell carcinoma. Adrenal metastases were synchronous (≤6 months) in 73 (23%) patients and isolated in 213 (67%). The median disease-free interval was 18.5 months. Laparoscopic resection was used in 46% of patients. Surgery was limited to the adrenal gland in 73% of patients and R0 resection was achieved in 86% of cases. The median overall survival was 29 months (95% confidence interval, 24.69-33.30). The survival rates at 1, 2, 3, and 5 years were 80%, 61%, 42%, and 35%, respectively. Patients with renal cancer showed a median survival of 84 months, patients with NSCLC 26 months, and patients with colorectal cancer 29 months (P = .017). Differences in survival between metachronous and synchronous lesions were also significant (30 vs. 23 months; P = .038).
CONCLUSION
Surgical removal of adrenal metastasis is associated with long-term survival in selected patients.
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