Surgical treatment of lung cancer with adrenal metastasis

Bretcha-Boix, Pedro; Rami–Porta, Ramón; Mateu-Navarro, Miquel; Hoyuela, Carlos; Marco-Molina, Constancio

doi:10.1016/s0169-5002(99)00097-5

Cited by 29 publications

(24 citation statements)

References 20 publications

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“…In Mercier et al 's series, all patients had the primary removed before adrenalectomy, 26 while Bretcha-Boix et al performed adrenalectomy before lung resection in two-thirds of cases. 24 In Porte et al, 12 of the 22 patients (54.5%) were resected simultaneously at the time of lung resection, six of the 22 (27.3%) after lung resection, and four of 22 (18.2%) before. 27 Nine studies described receipt of neoadjuvant or adjuvant systemic therapy (or both), while a crude average of 16.1% of patients (range 9.1-20%; n=5 studies) received adjuvant adrenal bed RT.…”

Section: Surgical Resectionmentioning

confidence: 98%

“…Twelve of the 23 studies required the AM to be the only site of distant spread, while three others allowed extra-adrenal disease if it could also be approached radically, such as resection +/-postoperative RT for brain metastases. Many groups did not specify intrathoracic T stage, and nodal stage varied: some groups excluded LN positive patients altogether, 20,24 while the proportion of N2 disease in series where it was permitted varied from 14.3-70.8%. 21,[25][26] Pathologic confirmation of AM was more commonly performed in early publications, while positron emission tomography (PET) staging became routine later.…”

Section: Surgical Resectionmentioning

confidence: 99%

“…52 Imaging features that have been used to characterize metastases include size, growth rate, irregular contour, delayed washout of contrast, associated LN, local invasion/obliteration of fat planes, inferior vena cava (IVC) thrombus and heterogeneity. 24,49,54,55 However, CT scans can be falsely negative or underestimate lesion size when metastatic lesions do not alter the macroscopic structure of the gland. 56,57 Serum and urine studies, 20,54 along with MRI, 18,21 should be considered to rule out pheochromocytoma ( Table 7).…”

Section: Work-up and Patient Selectionmentioning

confidence: 99%

“…38 Biopsy of an adrenal mass in this setting remains controversial. It has been proposed as mandatory by some, 20,21,24,50,53 especially in a patient with potentially curable intrathoracic disease. 57 However, in many publications, only a minority of patients had histological confirmation prior to definitive therapy.…”

Section: Work-up and Patient Selectionmentioning

confidence: 99%

“…21,24,32,34 Tumor emboli in Batson's venous plexus can seed either adrenal, depending on transient blood pressure conditions. 61 Disease-free interval -that is, whether a metastasis presents synchronously or metachronously -is likely a surrogate for intrinsic biological aggressiveness, and therefore possibly route of spread.…”

Section: Pathophysiology Of Adrenal Metastasesmentioning

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: Surgical Resectionmentioning

confidence: 98%

Section: Surgical Resectionmentioning

confidence: 99%

Section: Work-up and Patient Selectionmentioning

confidence: 99%

Section: Work-up and Patient Selectionmentioning

confidence: 99%

Section: Pathophysiology Of Adrenal Metastasesmentioning

confidence: 99%

See 3 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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A rare case of long‐term survival from metachronous bilateral adrenal metastasis of lung adenocarcinoma after combined surgical removal and immunochemotherapy

et al. 2022

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The prognosis of adrenal metastasis from non-small cell lung cancer is very poor. A recent report described the efficacy of the surgical removal of adrenal metastasis when solitary. However, metachronous bilateral adrenal metastasis is extremely rare, and a treatment strategy has not been established. Case presentation: Herein, we describe a 52-year-old Asian male who presented with a right adrenal metastasis of non-small cell lung cancer 8 months after immunochemotherapy and surgical resection of the lung. He underwent combined systemic treatment and a laparoscopic right adrenalectomy; however, after 9 months, a metachronous left adrenal metastasis emerged. A subsequent laparoscopic left adrenalectomy and systemic treatment led to long-term progression-free survival. Conclusion:The appropriate surgical indication and combined systemic treatment of a metachronous bilateral adrenal metastasis in non-small cell lung cancer may extend the prognosis.

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Surgical management of adrenal metastases

Bradley

Strong

2014

Journal of Surgical Oncology

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In the presence of a history of cancer, adrenal masses are commonly, but not exclusively, metastases. Depending upon the status of the patient's ongoing cancer therapy, overall tumor burden, and performance score, adrenalectomy is a viable treatment option. Herein we review the prevalence, diagnostic evaluation, and selection for surgical treatment of adrenal metastases. Additional attention is paid to recent data supporting the safety and oncologic efficacy of laparoscopic adrenalectomy.

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Surgical treatment of lung cancer with adrenal metastasis

Cited by 29 publications

References 20 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?

A rare case of long‐term survival from metachronous bilateral adrenal metastasis of lung adenocarcinoma after combined surgical removal and immunochemotherapy

Surgical management of adrenal metastases

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