ADRENALECTOMY FOR ISOLATED METASTASES

Abstract

Background: Isolated adrenal gland metastases are not frequently finding. The aim of the present retrospective study was to estimate clinical and pathological parameters that could be used to predict survival after adrenalectomy. Material and methods: A total of 34 patients with adrenal gland masses suspected to be metastases was included in this study. The group of patients with isolated metastases was19 (56%) and a group of patients with adrenal adenomas -15 (44%). Results: The sample of patients consisted of 18 (53%) men and 16 (47%) women from 40 to 81 years old with a mean (±SD) age of 61.6±10.3 years, presented with adrenal mass suspected to be metastases. Nineteen (56%) of them had demonstrated metastases and 16 (84%) metachronous with median overall survival (OS) 54.6 (range 43-66) months. Median OS in the group with metastases was 22.6 months. Lung carcinoma was the most common primary tumour metastasizing in the adrenal gland – 58% of all metastases with a disease-free interval (DFI) of 13 months. It was presented by shorter median survival than the rest primary tumour types (37.8 vs. 96.7months; log-rank test, p=0.028). In the multivariate Cox’s hazard analysis of the surgical technique was found to be an independent prognostic factor (p=0.047), together with lung carcinoma vs. renal cell carcinoma (p=0.045). Conclusion: Adrenalectomy due to isolated metastases in the adrenal glands showed the median overall survival of 22.6 months. Shorter survival periods were associated with lung carcinoma, DFI<12months, conversion to open surgery, synchronous metastases, but not with age, tumour size or resection status.

Keywords

• adrenal gland
• adrenal metastases
• adrenalectomy
• laparoscopic adrenalectomy