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

Endocrine. 2015 Sep;50(1):187-92. doi: 10.1007/s12020-015-0596-8. Epub 2015 Apr 12.

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.

MeSH terms

  • Adrenal Gland Neoplasms / mortality
  • Adrenal Gland Neoplasms / secondary
  • Adrenal Gland Neoplasms / surgery*
  • Adrenalectomy / methods*
  • Adult
  • Aged
  • Carcinoma, Non-Small-Cell Lung / mortality
  • Carcinoma, Non-Small-Cell Lung / pathology*
  • Carcinoma, Non-Small-Cell Lung / surgery
  • Disease-Free Survival
  • Female
  • Follow-Up Studies
  • Humans
  • Laparoscopy / methods*
  • Lung Neoplasms / mortality
  • Lung Neoplasms / pathology*
  • Lung Neoplasms / surgery
  • Male
  • Middle Aged
  • Neoplasm Metastasis
  • Retrospective Studies
  • Treatment Outcome