Adrenalectomy for metastasis: long-term results and predictors of survival

Solaini, Leonardo; Ministrini, Silvia; Tomasoni, Matteo; Merigo, Giulia; Gaverini, Giacomo; Bertoloni, Giam Paolo; Tiberio, Guido A M

doi:10.1007/s12020-015-0596-8

Cited by 17 publications

(14 citation statements)

References 21 publications

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“…Adrenal metastasectomy can prolong survival in lung cancer patients with solitary adrenal metastasis. Many studies suggest that LA is a safe and feasible technique in cases of adrenal metastasis, with acceptable outcomes [30,31]; however, SM+ remains a major concern and occurred in 1 of 5 patients with RCC metastasis and in 6 of 9 patients with lung cancer metastasis in the present study.…”

Section: Discussionmentioning

confidence: 50%

The Pathologic Point of View of Laparoscopic Adrenalectomy in the Era of Radiologic Imaging: A Multicenter Retrospective Study

Tonyalı

Ataç²,

Eroğlu³

et al. 2016

Urol Int

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Introduction/Aim: This study aimed to determine if laparoscopic adrenalectomy (LA) is feasible for the treatment of adrenal malignancies and metastasis, and to review the final pathology findings in order to clarify the indications for surgery. Materials and Method: The medical records of all patients that underwent LA at 3 university hospitals between January 1, 2008, and May 1, 2015, were retrospectively reviewed. Results: In total, 189 laparoscopic adrenalectomies were completed successfully. Mean duration of surgery was 79.3 ± 38.6 min and mean estimated intraoperative blood loss was 39.9 ml. Intraoperatively, 4 patients had major complications: spleen injury (n = 1), renal vein injury (n = 2) and diaphragm injury (n = 2). Histopathological examination showed that there were 20 different types of lesions. Surgical margins (SMs) were tumor free in 95.2% of the patients. Moreover, SMs were tumor free in all patients with adrenocortical carcinomas; however, positive margins were noted in 7 of 23 patients (30.4%) with malignant adrenal tumors. Conclusions: The present findings support the use of laparoscopy for metastatic adrenal masses, despite a high positive margin rate. LA is a safe, feasible and cost-effective procedure for the management of benign and malignant adrenal masses.

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Section: Discussionmentioning

confidence: 50%

The Pathologic Point of View of Laparoscopic Adrenalectomy in the Era of Radiologic Imaging: A Multicenter Retrospective Study

Tonyalı

Ataç²,

Eroğlu³

et al. 2016

Urol Int

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“…Possibly threatening essential adrenal tumors and singular adrenal metastases, once considered contraindications for the laparoscopic methodology, are presently being uprooted laparoscopically in a few foci [2]. The suitability of the laparoscopic way to deal with essential adrenal carcinomas remains the center of level-headed discussions [3]. A healing laparoscopic resection consolidates the oncologic standards of the open strategy, maintaining a strategic distance from crack of the tumor container.…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic Treatment of Adrenal Tumors: A Single-Center Experience with 58 Patients

Arı¹,

Buyukasik²,

Tatar³

et al. 2016

Surgery Research and Practice

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Background. The aim of this study is to discuss the laparoscopic approach and assess the immunohistochemical expression profiles of synaptophysin, Ki-67, and inhibin and patient outcomes in adrenal masses through a series of cases treated at our institution. Method. The study was conducted on 58 patients who were diagnosed with adrenal masses. All cases were operated on laparoscopically for adrenal masses. Results. Both inhibin and synaptophysin were found positive in 45 patients (77,6%). Ki-67 was negative in 11 patients, whereas it was found positive in 42 with a rate of 1%. The size of the masses ranged from 1 up to 9 cm (mean 4,3 ± 1,5). Urine hormone excretion was measured within normal ranges in 47 out of 58 patients (81%). Most of the diagnosed patients were harboring Cortical Adenoma (n: 38; 65,5%). All of the masses were successfully resected without complication except 3 patients. Because of complications of bleeding, the operation was converted to open surgery for 2 patients. Conclusion. Morbidity, mortality, and healing were comparable, regardless of tumor size, yet involvement in both laparoscopic and adrenal surgery was required. Our results suggested that laparoscopic adrenalectomy should replace open surgery as the standard treatment for most adrenal masses.

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“…28 Local relapse (LR) occurred on average in 14% (n=8; range 0-25%), with one additional study describing no LR after R0/R1 resections, but 11% local progression after an R2 resection. 29 LRs have been associated with capsular invasion 26 and intraoperative tumor rupture, 30 but not particularly impacted by postoperative RT. 26 Surgical complications and postoperative mortality are uncommonly described ( Table 2).…”

Section: Median Survivalmentioning

confidence: 97%

Adrenal Oligometastases Secondary to Non-small Cell Lung Cancer—What is the Optimal Treatment Approach?

Thomsen¹,

Fairchild²

2017

Oncology &Amp; Hematology Review (US)

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B ackground: Five-year overall survival (OS) for patients with stage IV non-small cell lung cancer (NSCLC) is a dismal 1%. However, approximately 7% have limited or solitary metastases, including to the adrenal gland. Radical treatment of these oligometastases (OM) could increase local control and improve OS. Our objective was to critically analyze data describing aggressive treatment of adrenal OM secondary to NSCLC. Methods: A literature search examining English publications describing surgery or radiotherapy (RT) was performed, supplemented by searching reference lists. Case reports of three or fewer patients, and articles from which NSCLC-or adrenal-specific clinical outcomes could not be abstracted, were excluded. Results: Twenty-nine studies met eligibility criteria (521 patients), 26 retrospective. No publications directly compare modalities. Four surgery studies described contemporaneous patients treated with palliative chemotherapy (CH) alone. Reported median OS ranged from 9.5-64 months after adrenalectomy, 8-23 months after RT, and 6-8.5 months after CH. Local failure after surgery was 14%, with response rates after RT 57-75%. Both appear well-tolerated. Conclusions: In patients with an adrenal OM secondary to NSCLC, aggressive treatment should be considered. However, due to the paucity of high quality evidence, it is unclear at present whether this approach alters the natural history of the disease.

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Adrenalectomy for metastasis: long-term results and predictors of survival

Cited by 17 publications

References 21 publications

The Pathologic Point of View of Laparoscopic Adrenalectomy in the Era of Radiologic Imaging: A Multicenter Retrospective Study

The Pathologic Point of View of Laparoscopic Adrenalectomy in the Era of Radiologic Imaging: A Multicenter Retrospective Study

Laparoscopic Treatment of Adrenal Tumors: A Single-Center Experience with 58 Patients

Adrenal Oligometastases Secondary to Non-small Cell Lung Cancer—What is the Optimal Treatment Approach?

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