Surgical treatment of solitary adrenal metastases from lung carcinoma

Raviv, Gil; Klein, Ehud; Yellin, Alon; Schneebaum, Shlomo; Ben-Ari, G

doi:10.1002/jso.2930430212

Cited by 54 publications

(19 citation statements)

References 8 publications

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“…The incidence of adrenal metastasis is low, rendering it unlikely to conduct a well-controlled randomized prospective trial comparing surgical versus non-surgical management. Adrenalectomy has been reported to increase survival for patients with adrenal metastatic lung carcinoma (12)(13)(14)(15), renal cell carcinoma (16), colorectal carcinoma (17,18) and melanoma (19,20). However, such reports came from small series or, in certain situations, from case reports.…”

Section: Discussionmentioning

confidence: 99%

Adrenalectomy may increase survival of patients with adrenal metastases

Zheng

Zhang

et al. 2012

Oncol Lett

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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.

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Section: Discussionmentioning

confidence: 99%

Adrenalectomy may increase survival of patients with adrenal metastases

Zheng

Zhang

et al. 2012

Oncol Lett

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“…Synchronous brain or adrenal metastasectomy is the recommended treatment if the tumor in the lung can be totally resected (7)(8)(9). However, we could not identify any suggestions for the appropriate synchronous treatment of solitary bone metastasis and NSCLC.…”

Section: Introductionmentioning

confidence: 87%

Effect of synchronous solitary bone metastasectomy and lung cancer resection on non-small cell lung cancer patients

Zhao

Gao

et al. 2016

Oncology Letters

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Abstract. Lung cancer is the most frequent cause of cancer-associated mortality among men and women globally. The skeleton is one of the most common metastatic sites. The majority of patients exhibiting bone metastases are treated using systemic therapy or symptom-based palliative approaches without surgery. The present study attempted to improve the therapeutic effects of synchronous surgeries in resectable non-small cell lung cancer patients exhibiting solitary bone metastasis. A total of 5 patients underwent synchronous lung cancer resections and solitary bone metastasectomies between October 2009 and November 2011 in the Department of Cardiothoracic Surgery, Shanghai Sixth People's Hospital (Shanghai, China). All patients had received fluorodeoxyglucose positron emission tomography-computed tomography or bone scintigraphy to demonstrate the presence of solitary bone metastasis and to exclude the presence of metastases at alternative sites. The patients received standard lung cancer and mediastinal lymph node resections. In addition, bone lesions were assessed by orthopedists and operated on synchronously with standard procedures. Following surgery, all patients were administered standard chemotherapeutic regimens. Perioperative indicators, including time for thoracic drainage, length of hospital stay, incidence of post-operative complications and progression-free survival (PFS) time, were observed. The average time for post-operative drainage was 4.6±1.1 days, and the average length of post-operative hospitalization was 8.8±2.2 days. All procedures were performed safely with no serious complications. The PFS of the patients was 13.2±7.7 months. While 2 patients presenting with spinal metastases succumbed at ~1 year post-surgery, the remaining 3 patients presenting with limb bone metastases survived for >16 months post-surgery, and were alive at the last follow-up. In conclusion, the present study indicated that a synchronous metastasectomy and lung tumor resection is a safe method of treatment. The PFS time and survival results demonstrated that on the rare occasion that a patient exhibits solitary bone metastasis, aggressive surgical treatment may be a potential therapeutic option.

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“…If an adrenal metastasis is found and the lung lesion is curable, resection has produced some long-term survivors (category 3). 259,260 However, resection generated major disagreement among the panel members For patients with T1ab or 2ab, N1 or T3, N0 disease and negative surgical margins, the panel recommends chemotherapy (category 1) or chemoradiation (category 3) and chemotherapy for patients with adverse factors (e.g., inadequate mediastinal lymph node dissection, extracapsular spread, multiple positive hilar nodes, and close margins). If surgical margins are positive (T1ab-2ab, N1 or T3, N0), options include re-resection and chemotherapy, or chemoradiation and chemotherapy.…”

Section: Stage IV Diseasementioning

confidence: 99%