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Adrenalectomy for metastasis: long-term results and predictors of survival

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Abstract

The purpose of this study was to analyze our experience with surgically treated isolated adrenal metastases in order to find those factors which can significantly affect survival. This method includes a retrospective single-center chart review. We evaluated how overall survival and disease-free survival (DFS) were influenced by demographic, tumor, and procedure-related variables. Thirty-seven adrenalectomies were performed in 34 patients. Procedures included 25 laparoscopic and 12 open adrenalectomies. Median follow-up was 49 months. Median overall survival was 63 months. Patients submitted to laparoscopic approach had a median survival of 57 months while it was 65 months for those who underwent open procedure (p = 0.67). DFS was 30 months, and these were 35 and 25 months after laparoscopic approach and open approach, respectively (p = 0.59). The concurrent resection of the adrenal metastasis with the primary tumor was the only factor influencing DFS (HR 6.8 95 % CI 1.2–37.3, p = 0.02). Patients with non-small cell lung cancer (n = 15) had a median survival of 63 months and DFS of 35 months. Our experience confirms that adrenalectomy, regardless of the surgical approach, can offer durable disease-free and overall survival outcomes for surgical candidates with isolated adrenal metastases.

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References

  1. H.L. Abrams, R. Spiro, N. Goldstein, Metastases in carcinoma: analysis of 1000 autopsied cases. Cancer 3(1), 74–85 (1950)

    Article  CAS  PubMed  Google Scholar 

  2. C.T. Bradley, V.E. Strong, Surgical management of adrenal metastases. J. Surg. Oncol. 109(1), 31–35 (2014). doi:10.1002/jso.23461

    Article  PubMed  Google Scholar 

  3. K.Y. Lam, C.Y. Lo, Metastatic tumours of the adrenal glands: a 30-year experience in a teaching hospital. Clin. Endocrinol. 56(1), 95–101 (2002)

    Article  Google Scholar 

  4. J.J. Sancho, F. Triponez, X. Montet, A. Sitges-Serra, Surgical management of adrenal metastases. Langenbecks Arch. Surg. 397(2), 179–194 (2012). doi:10.1007/s00423-011-0889-1

    Article  PubMed  Google Scholar 

  5. J. Uberoi, R. Munver, Surgical management of metastases to the adrenal gland: open, laparoscopic, and ablative approaches. Curr. Urol. Rep. 10(1), 67–72 (2009)

    Article  PubMed  Google Scholar 

  6. G.M. Howell, S.E. Carty, M.J. Armstrong, M.T. Stang, K.L. McCoy, D.L. Bartlett, L. Yip, Outcome and prognostic factors after adrenalectomy for patients with distant adrenal metastasis. Ann. Surg. Oncol. 20(11), 3491–3496 (2013). doi:10.1245/s10434-013-3050-2

    Article  PubMed  Google Scholar 

  7. E.C. Hwang, I. Hwang, S.I. Jung, T.W. Kang, D.D. Kwon, S.H. Heo, J.E. Hwang, S.G. Kang, S.H. Kang, J.G. Lee, J.J. Kim, J. Cheon, Prognostic factors for recurrence-free and overall survival after adrenalectomy for metastatic carcinoma: a retrospective cohort pilot study. BMC Urol. 14, 41 (2014). doi:10.1186/1471-2490-14-41

    Article  PubMed Central  PubMed  Google Scholar 

  8. X. Ma, H. Li, X. Zhang, Q. Huang, B. Wang, T. Shi, D. Hu, Q. Ai, S. Liu, J. Gao, Y. Yang, J. Dong, T. Zheng, Modified anatomical retroperitoneoscopic adrenalectomy for adrenal metastatic tumor: technique and survival analysis. Surg. Endosc. 27(3), 992–999 (2013). doi:10.1007/s00464-012-2553-4

    Article  PubMed  Google Scholar 

  9. P. Moreno, A. de la Quintana Basarrate, T.J. Musholt, I. Paunovic, M. Puccini, O. Vidal, J. Ortega, J.L. Kraimps, E. Bollo Arocena, J.M. Rodriguez, O. Gonzalez Lopez, C.D. Del Pozo, M. Iacobone, E. Veloso, J.M. Del Pino, I. Garcia Sanz, D. Scott-Coombes, J. Villar-Del-Moral, J.I. Rodriguez, J. Vazquez Echarri, C. Gonzalez Sanchez, M.T. Gutierrez Rodriguez, I. Escoresca, J. NunoVazquez-Garza, E. Tobalina Aguirrezabal, J. Martin, M.F. Candel Arenas, K. Lorenz, J.M. Martos, J.M. Ramia, Adrenalectomy for solid tumor metastases: results of a multicenter European study. Surgery 154(6), 1215–1222 (2013). doi:10.1016/j.surg.2013.06.021. discussion 1222–1213

    Article  PubMed  Google Scholar 

  10. A. Muth, F. Persson, S. Jansson, V. Johanson, H. Ahlman, B. Wangberg, Prognostic factors for survival after surgery for adrenal metastasis. Eur. J. Surg. Oncol. 36(7), 699–704 (2010). doi:10.1016/j.ejso.2010.04.002

    Article  CAS  PubMed  Google Scholar 

  11. V.E. Strong, M. D’Angelica, L. Tang, F. Prete, M. Gonen, D. Coit, K.A. Touijer, Y. Fong, M.F. Brennan, Laparoscopic adrenalectomy for isolated adrenal metastasis. Ann. Surg. Oncol. 14(12), 3392–3400 (2007). doi:10.1245/s10434-007-9520-7

    Article  PubMed  Google Scholar 

  12. B.J. Vazquez, M.L. Richards, C.M. Lohse, G.B. Thompson, D.R. Farley, C.S. Grant, M. Huebner, J. Moreno, Adrenalectomy improves outcomes of selected patients with metastatic carcinoma. World J. Surg. 36(6), 1400–1405 (2012). doi:10.1007/s00268-012-1506-3

    Article  PubMed  Google Scholar 

  13. C. Zerrweck, R. Caiazzo, B. Clerquin, G. Donatini, A. Lamblin, Z. El Khatib, L. Arnalsteen, B. Carnaille, F. Pattou, Renal origin and size are independent predictors of survival after surgery for adrenal metastasis. Ann. Surg. Oncol. 19(11), 3621–3626 (2012). doi:10.1245/s10434-012-2464-6

    Article  PubMed  Google Scholar 

  14. J.T. Adler, E. Mack, H. Chen, Equal oncologic results for laparoscopic and open resection of adrenal metastases. J. Surg. Res. 140(2), 159–164 (2007). doi:10.1016/j.jss.2006.08.035

    Article  PubMed  Google Scholar 

  15. L. Solaini, L. Arru, G. Merigo, M. Tomasoni, F. Gheza, G.A. Tiberio, Advanced sealing and dissecting devices in laparoscopic adrenal surgery. JSLS 17(4), 622–626 (2013). doi:10.4293/108680813X13693422520350

    Article  PubMed Central  PubMed  Google Scholar 

  16. G.A. Tiberio, L. Solaini, L. Arru, G. Merigo, G.L. Baiocchi, S.M. Giulini, Factors influencing outcomes in laparoscopic adrenal surgery. Langenbecks Arch. Surg. 398(5), 735–743 (2013). doi:10.1007/s00423-013-1082-5

    Article  PubMed  Google Scholar 

  17. A. Gunjur, C. Duong, D. Ball, S. Siva, Surgical and ablative therapies for the management of adrenal ‘oligometastases’—A systematic review. Cancer Treat. Rev. 40(7), 838–846 (2014). doi:10.1016/j.ctrv.2014.04.001

    Article  PubMed  Google Scholar 

  18. M. Lucchi, P. Dini, M.C. Ambrogi, P. Berti, G. Materazzi, P. Miccoli, A. Mussi, Metachronous adrenal masses in resected non-small cell lung cancer patients: therapeutic implications of laparoscopic adrenalectomy. Eur. J. Cardiothorac. Surg. 27(5), 753–756 (2005). doi:10.1016/j.ejcts.2005.01.047

    Article  PubMed  Google Scholar 

  19. O. Mercier, E. Fadel, M. de Perrot, S. Mussot, F. Stella, A. Chapelier, P. Dartevelle, Surgical treatment of solitary adrenal metastasis from non-small cell lung cancer. J. Thorac. Cardiovasc. Surg. 130(1), 136–140 (2005). doi:10.1016/j.jtcvs.2004.09.020

    Article  PubMed  Google Scholar 

  20. D.J. Raz, M. Lanuti, H.C. Gaissert, C.D. Wright, D.J. Mathisen, J.C. Wain, Outcomes of patients with isolated adrenal metastasis from non-small cell lung carcinoma. Ann. Thorac. Surg. 92(5), 1788–1792 (2011). doi:10.1016/j.athoracsur.2011.05.116. discussion 1793

    Article  PubMed  Google Scholar 

  21. P. Sastry, A. Tocock, A.S. Coonar, Adrenalectomy for isolated metastasis from operable non-small-cell lung cancer. Interact. Cardiovasc. Thorac. Surg. 18(4), 495–497 (2014). doi:10.1093/icvts/ivt526

    Article  PubMed Central  PubMed  Google Scholar 

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Acknowledgments

The authors are grateful to Mr. Richard Humphies (BA Hons English Literature) for his precious help in revising the English language of the manuscript.

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The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Medical and Surgical Sciences, Surgical Clinic, University of Brescia, Pl.e Spedali Civili 1, Brescia, Italy

    Leonardo Solaini, Silvia Ministrini, Matteo Tomasoni, Giulia Merigo, Giacomo Gaverini, Giam Paolo Bertoloni & Guido AM Tiberio

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  1. Leonardo Solaini
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  2. Silvia Ministrini
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  3. Matteo Tomasoni
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  4. Giulia Merigo
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  7. Guido AM Tiberio
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Correspondence to Leonardo Solaini.

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Solaini, L., Ministrini, S., Tomasoni, M. et al. Adrenalectomy for metastasis: long-term results and predictors of survival. Endocrine 50, 187–192 (2015). https://doi.org/10.1007/s12020-015-0596-8

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  • DOI: https://doi.org/10.1007/s12020-015-0596-8

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