Clinical Experience of Isolated Metachronous Adrenal Gland Metastases from Solid Primary Carcinomas
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Purpose: Owing to the development of improved techniques, the use of adrenal gland surgery for the treatment of metachronous metastatic adrenal tumors originating from primary carcinomas has increased. Here, we have analyzed the postoperative outcomes of patients who received surgical treatment for isolated metastatic adrenal gland originated from solid primary carcinomas. Methods: Patients who underwent metastatic adrenalectomy after treatment of the primary carcinoma at the Asan Medical Center from 2000 to 2010 were included. Clinicopathological parameters were analyzed to determine the prognostic outcomes. Results: Our study cohort consisted of 21 patients with hepatocellular carcinoma (n=10), lung carcinoma (n=8), and colorectal carcinoma (n=3). The mean age was 54.6 years old. The mean overall survival (OS) duration was 78.5 months. Disease-specific recurrence-free survival (RFS) after metastatic adrenalectomy was significantly longer when the interval between primary carcinoma treatment and metachronous metastasis to the adrenal glands was ≥16 months (P=0.043). There was no significant difference in disease-specific RFS between patients who underwent open adrenalectomy (OA) vs. laparoscopic adrenalectomy (LA) (P=0.063). Conclusion: Surgical treatment should be recommended for isolated metachronous adrenal gland metastases when the interval between primary carcinoma treatment and metastasis is ≥16 months to achieve better disease-specific RFS. LA was not inferior to OA.
Abstract
Purpose: Owing to the development of improved techniques, the use of adrenal gland surgery for the treatment of metachronous metastatic adrenal tumors originating from primary carcinomas has increased. Here, we have analyzed the postoperative outcomes of patients who received surgical treatment for isolated metastatic adrenal gland originated from solid primary carcinomas. Methods: Patients who underwent metastatic adrenalectomy after treatment of the primary carcinoma at the Asan Medical Center from 2000 to 2010 were included. Clinicopathological parameters were analyzed to determine the prognostic outcomes. Results: Our study cohort consisted of 21 patients with hepatocellular carcinoma (n=10), lung carcinoma (n=8), and colorectal carcinoma (n=3). The mean age was 54.6 years old. The mean overall survival (OS) duration was 78.5 months. Disease-specific recurrence-free survival (RFS) after metastatic adrenalectomy was significantly longer when the interval between primary carcinoma treatment and metachronous metastasis to the adrenal glands was ≥16 months (P=0.043). There was no significant difference in disease-specific RFS between patients who underwent open adrenalectomy (OA) vs. laparoscopic adrenalectomy (LA) (P=0.063). Conclusion: Surgical treatment should be recommended for isolated metachronous adrenal gland metastases when the interval between primary carcinoma treatment and metastasis is ≥16 months to achieve better disease-specific RFS. LA was not inferior to OA.
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