Metastasis to the adrenal gland: The emerging role of laparoscopic surgery Journal Article


Authors: Sarela, A. I.; Murphy, I.; Coit, D. G.; Conlon, K. C. P.
Article Title: Metastasis to the adrenal gland: The emerging role of laparoscopic surgery
Abstract: Background: It is unclear whether resection of clinically isolated metastasis to the adrenal gland improves survival. Also, the role of laparoscopic adrenalectomy (LA) for metastasis is controversial. This study aimed to (1) identify patients who are most likely to have prolonged survival after resection of adrenal metastasis and (2) compare oncological outcomes of LA and open adrenalectomy (OA). Methods: A retrospective review of 41 patients, who underwent either OA or LA for metastasis to the adrenal gland during 1997-2002 at a single institution, was conducted. Results: There were 20 women and 21 men, with a median age of 59 years. The most common disease was non-small-cell lung carcinoma (n = 23), followed by renal cell carcinoma (n = 6). With a median follow-up of 16 months, the overall five-year actuarial survival was 29% (median, 28 months). Four patients were actually alive at four years after adrenalectomy. Disease-free interval (DFI) > 6 months was the only significant predictor of improved survival. LA was performed for 11 patients. There was no difference in the incidence of positive resection-margins or survival between patients with OA or LA. Conclusions: Adrenalectomy for metastasis, with intent to prolong survival, should be offered to patients with favorable tumor biology, such as those with significant DFI. The oncological outcome from LA appears similar to that from OA. © 2003 The Society of Surgical Oncology, Inc.
Keywords: adult; cancer survival; clinical article; treatment outcome; aged; disease-free survival; middle aged; cancer surgery; retrospective studies; review; liver neoplasms; disease free survival; follow up; methodology; laparoscopy; laparoscopic surgery; metastasis; lung non small cell cancer; lung neoplasms; proportional hazards models; pathology; retrospective study; kidney carcinoma; lung tumor; survival time; proportional hazards model; liver tumor; intermethod comparison; neoplasm recurrence; time series analysis; statistics, nonparametric; adrenal tumor; adrenal gland neoplasms; adrenal metastasis; nonparametric test; secondary; adrenalectomy; kidney neoplasm; lung neoplasm; humans; human; male; female; article
Journal Title: Annals of Surgical Oncology
Volume: 10
Issue: 10
ISSN: 1068-9265
Publisher: Springer  
Date Published: 2003-12-01
Start Page: 1191
End Page: 1196
Language: English
DOI: 10.1245/aso.2003.04.020
PUBMED: 14654476
PROVIDER: scopus
DOI/URL:
Notes: Export Date: 25 September 2014 -- Source: Scopus
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  1. Abeezar Sarela
    9 Sarela
  2. Kevin C Conlon
    120 Conlon
  3. Daniel Coit
    542 Coit