Laparoscopic adrenalectomy for isolated adrenal metastasis Journal Article
| Authors: | Strong, V. E.; D'Angelica, M.; Tang, L.; Prete, F.; Gonen, M.; Coit, D.; Touijer, K. A.; Fong, Y.; Brennan, M. F. |
| Article Title: | Laparoscopic adrenalectomy for isolated adrenal metastasis |
| Abstract: | Background: Use of laparoscopy for isolated adrenal metastases is controversial. The aims of this study were to characterize patients with isolated adrenal metastases; compare operative characteristics of the laparoscopic adrenalectomy (LA) versus open adrenalectomy (OA) approach; and compare long-term oncological and surgical outcomes. Methods: Our adrenal resection database (1995-2006) identified 63 OA and 31 LA cases done for isolated adrenal metastases. Subset analysis was performed for all patients from isolated lung metastases (n = 39) and for all tumors smaller than 4.5 cm (n = 49). Results: Overall, local recurrence was 17%, median survival 30 months and 5-year estimated survival 31%. The only independent predictor of survival for all (n = 94) was adrenal tumor size less than 4.5 cm (P = 0.01). When comparing LA with OA, no differences in local recurrence, margin status, disease-free interval or overall survival were observed for the entire group, or for patients with metastases only from lung cancer (n = 39) or for those with tumors smaller than 4.5 cm (n = 49). LA provided significantly shorter operative time (175 vs 208 min, P = 0.04), lower estimated blood loss (EBL) (106 vs 749 cc, P < 0.0001), shorter length of hospital stay (2.8 vs 8.0 days, P < 0.0001) and fewer total complications (P < 0.0001). Conclusions: LA is equivalent to OA in terms of margin status, local recurrence, disease-free interval and overall survival. LA for metastatic adrenal lesions is safe, with equivalent long-term oncological outcomes providing the additional benefits of a minimally invasive technique. LA can be recommended as an appropriate initial approach for isolated adrenal metastases. © 2007 The Society of Surgical Oncology, Inc. |
| Keywords: | adult; cancer survival; controlled study; treatment outcome; middle aged; major clinical study; overall survival; follow-up studies; laparoscopy; laparoscopic surgery; tumor volume; bleeding; lung cancer; postoperative complication; postoperative complications; lung metastasis; hospitalization; tumor recurrence; operation duration; disease free interval; minimally invasive surgery; kaplan meier method; metastases; adrenal gland neoplasms; adrenal metastasis; laparoscopic; adrenalectomy; laparoscopic adrenalectomy; open adrenalectomy |
| Journal Title: | Annals of Surgical Oncology |
| Volume: | 14 |
| Issue: | 12 |
| ISSN: | 1068-9265 |
| Publisher: | Springer |
| Date Published: | 2007-12-01 |
| Start Page: | 3392 |
| End Page: | 3400 |
| Language: | English |
| DOI: | 10.1245/s10434-007-9520-7 |
| PUBMED: | 17665267 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 31" - "Export Date: 17 November 2011" - "CODEN: ASONF" - "Source: Scopus" |
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