Adrenal metastasectomy in the presence and absence of extraadrenal metastatic disease Journal Article
| Authors: | Russo, A. E.; Untch, B. R.; Kris, M. G.; Chou, J. F.; Capanu, M.; Coit, D. G.; Chaft, J. E.; D'Angelica, M. I.; Brennan, M. F.; Strong, V. E. |
| Article Title: | Adrenal metastasectomy in the presence and absence of extraadrenal metastatic disease |
| Abstract: | Objective: To determine if there are differences in overall survival (OS) or event-free survival (EFS) in patients with and without concomitant extraadrenal metastases undergoing adrenal metastasectomy. Background: There is growing interest in the use of local therapies in patients with oligometastatic disease. Previously published series have indicated that long-term survival is possible with resection. Adrenalectomy has been used to treat adrenal metastases in select patients. Methods: Patients who underwent adrenal metastasectomy from 1994 to 2015 were identified from a prospectively maintained institutional database of adrenalectomy patients, excluding adrenalectomies due to tumor extension or for palliation. Sites of disease, treatment history, and survival data were extracted from chart review. Results: One hundred seventy-four patients were included. Tumor histology included 68 nonsmall cell lung cancer, 34 renal cancer, 18 colorectal cancer, 11 melanoma cancer, 10 hepatocellular cancer, 8 sarcoma cancer, and 25 other cancers. The median follow-up among survivors was 5.2 (1-21) years. OS at 3 and 5 years was 50% and 40%, respectively. Patients with (n = 83) and without (n = 91) extra-adrenal metastases did not differ with respect to age, adrenal tumor size, or margin status. Median OS (3.3 years for patients with concomitant extra-adrenal metastases and 3.0 years for patients with isolated adrenal metastases; P = 0.816) and EFS (9.39 vs 9.59 months; P = 0.87) were similar. Factors negatively associated with OS included adrenal tumor size (P < 0.01), renal primary versus other (P < 0.01), and adrenal margin status (P < 0.01). Conclusions: In selected patients undergoing adrenal metastasectomy, there were no significant differences in OS or EFS between patients with and without concomitant extra-adrenal metastases. |
| Keywords: | surgery; resection; outcomes; metastasectomy; cell lung-cancer; oligometastases; adrenal metastases |
| Journal Title: | Annals of Surgery |
| Volume: | 270 |
| Issue: | 2 |
| ISSN: | 0003-4932 |
| Publisher: | Lippincott Williams & Wilkins |
| Date Published: | 2019-08-01 |
| Start Page: | 373 |
| End Page: | 377 |
| Language: | English |
| ACCESSION: | WOS:000480739600079 |
| DOI: | 10.1097/sla.0000000000002749 |
| PROVIDER: | wos |
| PUBMED: | 29578911 |
| PMCID: | PMC7485272 |
| Notes: | Article -- Source: Wos |
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