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Prognostic factors after adrenalectomy for adrenal metastasis

  • Urology - Original Paper
  • Published:
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Abstract

Purpose

Very few studies have sought prognostic factors after adrenalectomy for metastasis. The aim of this study was to assess prognostic factors for oncological outcomes after adrenalectomy for adrenal metastasis.

Methods

All adrenalectomies for metastases performed in seven centers between 2006 and 2016 were included in a retrospective study. Recurrence-free survival (RFS) and cancer-specific survival (CSS) were estimated using the Kaplan–Meier method. Prognostic factors for CSS and RFS were sought by Cox regression analyses.

Results

106 patients were included. The primary tumors were mostly renal (47.7%) and pulmonary (32.3%). RFS and CSS estimated rates at 5 years were 20.7% and 63.7%, respectively. In univariate analysis, tumor size (HR 3.83; p = 0.04) and the metastasis timing (synchronous vs. metachronous; HR 0.47; p = 0.02) were associated with RFS. In multivariate analysis, tumor size (HR 8.28; p = 0.01) and metastasis timing (HR 18.60; p = 0.002) were significant factors for RFS. In univariate analysis, the renal origin of the primary tumor (HR 0.1; p < 0.001) and the disease-free interval (DFI; HR 0.12; p = 0.02) were associated with better CSS, positive surgical margins with poorer CSS (HR 3.4; p = 0.01). In multivariate analysis, the renal origin of the primary tumor vs. pulmonary (HR 0.13; p = 0.03) and vs. other origins (HR 0.10; p = 00.4) and the DFI (HR 0.01; p = 0.009) were prognostic factors for CSS.

Conclusion

In this study, tumor size and synchronous occurrence of the adrenal metastasis were associated with poorer RFS. Renal origin of the primary tumor and longer DFI were associated with better CSS. These prognostic factors might help for treatment decision in the management of adrenal metastasis.

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Abbreviations

LA:

Laparoscopic adrenalectomy

CT scan:

Computed tomography

CSS:

Cancer-specific survival

RFS:

Recurrence-free survival

OS:

Overall survival

DFI:

Disease-free interval

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Authors and Affiliations

  1. Department of Urology, CHU Rennes, Rennes, France

    A. Goujon, K. Bensalah, A. Manunta & B. Peyronnet

  2. Department of Urology, CHU Brest, Brest, France

    N. Schoentgen, G. Fournier & V. Joulin

  3. Department of Urology, CHU Amiens, Amiens, France

    R. Betari & F. Saint

  4. Department of Urology, CHU Toulouse, Toulouse, France

    M. Thoulouzan, M. Roumiguie, M. Soulie & E. Huyghe

  5. Department of Urology, CHU Tours, Tours, France

    V. Vanalderwerelt, B. Pradere & F. Bruyere

  6. Department of Urology, CHU Rouen, Rouen, France

    S. Oumakhlouf, P. Grise & F.-X. Nouhaud

  7. Department of Urology, CH Orleans, Orléans, France

    N. Brichart & A. Rammal

Authors
  1. A. Goujon
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  2. N. Schoentgen
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  4. M. Thoulouzan
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  5. V. Vanalderwerelt
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  6. S. Oumakhlouf
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  7. N. Brichart
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  8. B. Pradere
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  11. M. Soulie
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  12. G. Fournier
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  13. K. Bensalah
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  14. F. Bruyere
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  15. P. Grise
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  16. V. Joulin
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  17. A. Manunta
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  18. F. Saint
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  19. E. Huyghe
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  20. F.-X. Nouhaud
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  21. B. Peyronnet
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Contributions

AG: project development, data collection, and manuscript writing. NS: project development, data collection, and data analysis. RB: project development and data collection. MT: project development and data collection. VV: data collection. SO: data collection. NB: data collection. BP: project development and data analysis. MR: data collection. AR: project development and data collection. MS: project development and data collection. GF: project development. KB: project development. FB: project development. PG: project development and data collection. VJ: project development and data collection. AM: project development and manuscript writing. FS: project development and data collection. EH: project development and data collection. F-XN: project development and data collection. BP: project development, data collection, data analysis, and manuscript writing.

Corresponding author

Correspondence to A. Goujon.

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The authors declare that they have no conflict of interest.

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Data are available at CHU de Rennes.

Ethical approval retrospective studies

The study received approval of the local committees.

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Goujon, A., Schoentgen, N., Betari, R. et al. Prognostic factors after adrenalectomy for adrenal metastasis. Int Urol Nephrol 52, 1869–1876 (2020). https://doi.org/10.1007/s11255-020-02496-w

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  • DOI: https://doi.org/10.1007/s11255-020-02496-w

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