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Annals of Surgical Oncology

, Volume 20, Issue 11, pp 3491–3496 | Cite as

Outcome and Prognostic Factors After Adrenalectomy for Patients with Distant Adrenal Metastasis

  • Gina M. Howell
  • Sally E. Carty
  • Michaele J. Armstrong
  • Michael T. Stang
  • Kelly L. McCoy
  • David L. Bartlett
  • Linwah Yip
Endocrine Tumors

Abstract

Background

The purpose of this study was to describe a single-institution experience with adrenal metastasectomy and to elucidate factors that may bear prognostic significance.

Methods

This is a single-center, retrospective review of patients with adrenal metastasis who underwent adrenalectomy performed with curative intent between 2000 and 2012. The Kaplan–Meier method was used to evaluate overall survival from time of adrenalectomy to death or last follow-up. Primary endpoint was death from any cause. Clinical variables were examined for association with survival.

Results

The study included 62 patients with mean age of 60 (±12) years; 55 % (34 of 62) were male, 85 % (53 of 62) presented with isolated adrenal metastasis, and 82 % (51 of 62) had metachronous disease with median disease-free interval (DFI) of 22 months (range, 6–217 months). Non-small cell lung cancer (NSCLC) was the most common primary comprising 50 % of cases. Median survival for the study population was 30 months (range, 1–145 months) and 5-year survival was 31 %. Patients with NSCLC had significantly shortened survival compared with non-NSCLC with median and 5-year survival of 17 versus 47 months and 27 % versus 38 %, respectively (p = .033). Synchronous metastasis (p = .028) and DFI < 12 months (p = .038) were also associated with worse survival outcome, though male gender (p = .69) and oligometastatic disease (p = .62) were not.

Conclusions

Adrenal metastasectomy resulted in median survival of 30 months and 5-year survival of 31 %. Shorter survival was associated with lung primary, short disease-free interval, and synchronous metastasis, but not with the presence of oligometastatic disease provided that the primary cancer and additional metastatic lesions were adequately controlled and amenable to resection.

Keywords

Adrenal Metastasis Adrenal Lesion Synchronous Metastasis Metachronous Lesion Oligometastatic Disease 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Society of Surgical Oncology 2013

Authors and Affiliations

  • Gina M. Howell
    • 1
  • Sally E. Carty
    • 1
  • Michaele J. Armstrong
    • 1
  • Michael T. Stang
    • 1
  • Kelly L. McCoy
    • 1
  • David L. Bartlett
    • 1
  • Linwah Yip
    • 1
  1. 1.Division of Endocrine Surgery and Surgical Oncology, Department of SurgeryUniversity of Pittsburgh School of MedicinePittsburghUSA

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