J Endocr Surg.  2017 Jun;17(2):73-79. 10.16956/jes.2017.17.2.73.

Clinical Experience of Isolated Metachronous Adrenal Gland Metastases from Solid Primary Carcinomas

• Cho MJ
• Cho JW
• Lee YM
• Sung TY
• Yoon JH
• Chung KW
• Hong SJ

• KMID: 2383824
• DOI: http://doi.org/10.16956/jes.2017.17.2.73

Abstract

PURPOSE
Owing to the development of improved techniques, the use of adrenal gland surgery for the treatment of metachronous metastatic adrenal tumors originating from primary carcinomas has increased. Here, we have analyzed the postoperative outcomes of patients who received surgical treatment for isolated metastatic adrenal gland originated from solid primary carcinomas.
METHODS
Patients who underwent metastatic adrenalectomy after treatment of the primary carcinoma at the Asan Medical Center from 2000 to 2010 were included. Clinicopathological parameters were analyzed to determine the prognostic outcomes.
RESULTS
Our study cohort consisted of 21 patients with hepatocellular carcinoma (n=10), lung carcinoma (n=8), and colorectal carcinoma (n=3). The mean age was 54.6 years old. The mean overall survival (OS) duration was 78.5 months. Disease-specific recurrence-free survival (RFS) after metastatic adrenalectomy was significantly longer when the interval between primary carcinoma treatment and metachronous metastasis to the adrenal glands was ≥16 months (P=0.043). There was no significant difference in disease-specific RFS between patients who underwent open adrenalectomy (OA) vs. laparoscopic adrenalectomy (LA) (P=0.063).
CONCLUSION
Surgical treatment should be recommended for isolated metachronous adrenal gland metastases when the interval between primary carcinoma treatment and metastasis is ≥16 months to achieve better disease-specific RFS. LA was not inferior to OA.

Keyword

Adrenal glands; Neoplasm metastasis; Neoplasms, second primary; Adrenalectomy; Survival

MeSH Terms

Adrenal Glands*
Adrenalectomy
Carcinoma, Hepatocellular
Chungcheongnam-do
Cohort Studies
Colorectal Neoplasms
Humans
Lung
Neoplasm Metastasis*
Neoplasms, Second Primary

Figure

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  Fig. 1 OS rate of all patients after the initial treatment of primary carcinoma. OS = overall survival.

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  Fig. 2 Disease-specific RFS rate of all patients after the metastatic adrenalectomy. RFS = recurrence-free survival.

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  Fig. 3 Disease-specific RFS rate of patients according to the interval between the initial primary carcinoma treatment and metastatic adrenalectomy. RFS = recurrence-free survival; DFI = disease-free interval.

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  Fig. 4 Disease-specific RFS rate of patients according to the types of adrenal surgery. RFS = recurrence-free survival; OA = open adrenalectomy; LA = laparoscopic adrenalectomy.

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