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[Adrenal metastasis in primary lung cancer]
1Cancer Institute (Hospital), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100021.
Objective:
To study the incidence, histologic types, clinical symptoms, response rates, and median survival time of adrenal metastasis in primary lung cancer.
Methods:
The clinical data were retrospectively evaluated in 96 out of 6,976 patients with adrenal metastasis in primary lung cancer between January 1984 and January 1997.
Results:
The incidence of adrenal metastasis was 1.38% (96/6,976) in 6,976 patients, 2.25% (37/1,643) in small cell lung cancer, 1.11% (59/5333) in non-small cell lung cancer. Abdominal pain and lumbago (excluding other reasons, for example, abdominal vertebrae and other abdominal organs were involved) occurred in 39% (37/96) in 96 patients. A overall response rate (CR + PR) was 43% in 54 patients who received chemotherapy (5 patients combined with irradiation) and could be evaluated. A median survival time was 7.17 (1-20) months in 96 patients.
Conclusions:
Primary lung cancer is easy to spread to adrenals. The incidence of adrenal metastasis is related to histologic types of primary lung cancer. Clinical symptoms include abdominal pain and lumbago. Surgical resection may be applied for a solitary adrenal metastasis after the primary tumor is removed. Chemotherapy is effective for patients with adrenal metastasis synchronous with other sites metastasis. The palliative radiation therapy can produce a high response rate in pain relief.