American Association of Endocrine SurgeonAdrenalectomy for solid tumor metastases: Results of a multicenter European study
Section snippets
Design and patients
This retrospective multicenter study was based on survey data provided by the Units of Endocrine Surgery of 30 medical institutions from 6 European countries (Italy, UK, Serbia, France, Germany, and Spain). All consecutive patients with adrenal metastases undergoing adrenalectomy in which the final histopathologic report showed explicit evidence of adrenal metastatic disease were included in the study. Exclusion criteria were as follows: Patients with inconclusive histopathologic diagnosis of
Results
Data from 317 patients who underwent adrenalectomy for adrenal metastatic disease from 1999 to 2011 were evaluated. The mean age was 58.9 ± 10.6 years, and 223 (70%) were men. Primary tumors were non-small cell lung cancer (NSCLC) in 148 patients, colorectal in 43, renal in 37, breast cancer in 11, melanoma in 11, and other in 67. The median DFI was 18.5 months (IQR, 6.6–37.3).
Adrenal metastases were synchronous in 73 (23%) patients. Isolated adrenal metastasis occurred in 234 (74%) patients.
Discussion
The main findings of this retrospective multicenter study of 317 patients with operative management of adrenal metastases from solid tumors is that removal of adrenal metastases, particularly metachronous isolated metastasis from renal cell carcinoma, is associated with favorable long-term outcome in terms of survival (median, 84 months). Also, in the multivariate analysis, treatment of the primary tumor (surgery or chemotherapy) and complete operative resection of the adrenal metastasis (R0)
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