Renal Origin and Size are Independent Predictors of Survival After Surgery for Adrenal Metastasis

Zerrweck, Carlos; Caïazzo, Robert; Clerquin, Baptiste; Donatini, Gianluca; Lamblin, Antoine; Khatib, Ziad El; Arnalsteen, Laurent; Carnaille, B.; Pattou, François

doi:10.1245/s10434-012-2464-6

Cited by 27 publications

(31 citation statements)

References 22 publications

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Section: Symptom Palliationmentioning

confidence: 99%

“…67,68 Pain may affect the lower chest, abdomen, back or flank, Review Lung Cancer mimicking hepatic, bone, or chest wall disease. 44,67,69 Pain may be severe enough to require opioids and impact negatively on QOL. 37 The left adrenal usually extends more cranially than the right; additionally, because the medial border of the left adrenal is closely related to the left celiac ganglion, a left-sided expanding lesion may be more likely to cause pain.…”

Section: Symptom Palliationmentioning

confidence: 99%

“…However, this did not retain prognostic significance on multivariate analysis. 67 In a series focusing on symptom improvement after RT, 16 (13 NSCLC) patients were treated palliatively for 14 left-and three right-sided lesions . 68 The remainder had minimal or no pain response.…”

Section: Symptom Palliationmentioning

confidence: 99%

“…20,26 While surgical or ablative therapy in the setting of N2 intrathoracic nodes remains controversial, 33,71 the presence of extra-adrenal OM which can also be approached radically does not appear to be a contraindication. 49,67,72 This is due to the absence of a significant difference in MS after aggressive therapy between patients with an isolated AM and those with OM disease, which includes an adrenal lesion. 73 Some authors advocate the "test of time" approach in synchronous presentations, utilizing systemic therapy (cytotoxic chemotherapy or targeted agents) for 3-12 months, to allow the natural history of the disease to declare itself.…”

Section: Recommendationsmentioning

confidence: 99%

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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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Section: Symptom Palliationmentioning

confidence: 99%

Section: Symptom Palliationmentioning

confidence: 99%

Section: Symptom Palliationmentioning

confidence: 99%

Section: Recommendationsmentioning

confidence: 99%

See 2 more Smart Citations

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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“…Several series have proven the lower morbidity of this approach in adrenal surgery (notably decreased complication rate and blood loss, shorter length of stay) [5][6]. Although most of the series of LA have shown similar surgical and oncological outcomes to those reported in the open era [7][8], the role of laparoscopy in the treatment of malignant adrenal tumors remains controversial. In recent years, two series have raised concern about the laparoscopic approach for resection of adrenal metastases.…”

Section: Introductionmentioning

confidence: 99%

Patient selection for laparoscopic excision of adrenal metastases: A multicenter cohort study

Gryn

Peyronnet

Manunta

et al. 2015

International Journal of Surgery

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Patient selection for laparoscopic excision of adrenal metastases: a multicenter cohort study. International Journal of Surgery, Elsevier, 2015, 24 Part A, pp.75-80. 10.1016/j.ijsu.2015 M A N U S C R I P T A C C E P T E D ABSTRACT:Introduction: The use of laparoscopy for the excision of adrenal metastasis remains controversial.We aimed to report oncological and perioperative outcomes of laparoscopic excision of adrenal metastases and to seek for predictive factors of unfavourable oncological outcomes. Results: Forty-three patients who underwent a total of 45 LA were included for analysis. There were 8 complications (17.8%). Positive surgical margins were found in 12 specimens (26.7%). After a median follow-up of 37 months, estimated overall survival rates were 89.5% and 51.5% at 1 year and 5 years, respectively. In multivariable analysis the only predictor of unfavourable surgical outcomes was a tumor size > 5 cm (OR= 20.5; p=0.001). In multivariate analysis the pulmonary (OR=0.3; p=0.008) or "other" (OR= 0.1; p=0.0006) origin of the primary tumor was the only prognostic factor of shorter cancer specific survival. Methods Conclusion:Laparoscopic resection of adrenal metastasis can be safely performed in most patients but is associated with an increased risk of positive surgical margins and postoperative complications in larger tumors (> 5 cm). Adrenalectomy provides better oncological outcomes in metastases from renal cell carcinoma compared to other primary tumors.

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Resection Versus Observation for Adrenal Gland Metastasis

Mercier

Feldman

Mitmaker

2018

Difficult Decisions in Endocrine Surgery

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Renal Origin and Size are Independent Predictors of Survival After Surgery for Adrenal Metastasis

Cited by 27 publications

References 22 publications

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

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

Patient selection for laparoscopic excision of adrenal metastases: A multicenter cohort study

Resection Versus Observation for Adrenal Gland Metastasis

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