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What is the best treatment modality for adrenal metastasis from hepatocellular carcinoma?
Joon Seong Park1, Dong Sup Yoon, Kyung Sik Kim
1Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.
Purpose:
This study aimed to analyze the effect of each therapeutic modality to clarify the treatment strategy for adrenal metastases from hepatocellular carcinoma (HCC).
Methods:
Adrenal metastasis from HCC was observed in 45 patients. Fifteen patients who were determined to have multi-organ metastasis including the adrenal glands were excluded, and the remaining 30 patients were reviewed.
Results:
The location of adrenal metastasis was right side, left side, and both in 17, 9, and 4 patients, respectively. Treatment for adrenal metastasis consisted of adrenalectomy in 5 patients, non-surgical treatment such as TACE, or chemotherapy and radiotherapy in 19 patients, while 6 patients received no treatment. The median survival duration was 11.05 months in the 30 patients with adrenal metastasis. In the 25 patients with well-controlled intrahepatic lesions, the median survival time of those patients who received adrenalectomy, non-surgical treatment, and no treatment was 21.41, 11.05, and 5.64 months, respectively. The difference in cumulative survival according to mode of treatment of adrenal metastasis in the well-controlled intrahepatic lesion group was statistically significant.
Conclusion:
We envisage increased benefit after adrenalectomy in terms of survival in patients with well controlled intrahepatic lesions at the time of adrenal metastasis and good general medical condition.
