Adrenalectomy may increase survival of patients with adrenal metastases

Abstract

Abstract. The much improved diagnostic accuracy of computed tomography (CT) and positron emission tomography (PET) has enabled urologists and medical oncologists to identify and treat more patients with metastases to the adrenal glands. The aim of this retrospective study was to analyze the clinical aspects of adrenal metastases in a series of patients and to evaluate the effect of adrenalectomy, by laparoscopic or open resection of adrenal metastases, on the survival of these patients. A total of 47 patients (32 males, 15 females) with metastatic disease in the adrenal glands were included in this study. Type B ultrasound and CT were utilized to diagnose the adrenal metastases. Open resection was performed in certain patients with primary tumor and adrenal metastasis. The results showed that adrenal metastases in these patients had various origins, including lung carcinoma, kidney carcinoma, breast cancer, melanoma and other uncharacterized carcinomas. The median survival of the 37 followed-up patients was 29.7±3.23 months (range, 2-62) after the diagnosis/surgical removal of adrenal metastases. The survival rate of the 31 patients with surgically removed adrenal metastases (average, 34.2±4.7 months; range 2-62) was higher than the survival rates of the 6 patients without surgical resection (average, 6.3±2.7 months; range, 4-8). The results of this study are in support of adrenalectomy for patients with adrenal metastases.

Adrenalectomy for Isolated Metastases

“…However, in cases of isolated adrenal metastases survival can be improved after adrenalectomy [3,[11][12][13]. In our 19 patients with isolated adrenal metastases, the mean estimate survival was 25.0 months, which according to the results of other authors [6,[15][16][17].…”

“…Long-term survival rates have been reported in patients after adrenalectomy due to metastatic disease, provided there was an isolated metastasis [3,[11][12][13]. In terms of surgical approach, numerous authors have reported safety and similar oncological results of laparoscopic adrenalectomy for metastases compared to open surgery [11,12,[14][15][16].…”

Metabolic and anatomic characteristics of benign and malignant adrenal masses on positron emission tomography/computed tomography: a review of literature

“…There is some evidence for survival advantage for surgical intervention for oligometastatic disease of the adrenals [80][81][82][83][84]. Other treatment approaches to oligometastatic disease include CT-guided ablation [85], radiotherapy, and stereotactic radiation treatments [86,87].…”

SBRT: A viable option for treating adrenal gland metastases

“…11,12 Surgery can be performed with an open resection or through laparoscopic approach. Laparoscopic adrenalectomy has been shown to improve patients' morbidity and to reduce hospitalization with a comparative oncological outcome compared to the open resection technique.…”