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Adrenal metastectomy is safe in selected patients
Minerva Angelica Romero Arenas1, Dawen Sui, Elizabeth G Grubbs
1Department of Surgical Oncology, The University of Texas M.D. Anderson Cancer Center, 1400 Pressler Dr., Unit 1484, Houston, TX, 77030, USA, MARomero@mdanderson.org.
World Journal of Surgery
|January 24, 2014
Summary
Adrenalectomy (ADX) for adrenal metastasis can be safe in select patients, with some achieving long-term survival. Laparoscopic ADX offers reduced morbidity without compromising oncologic outcomes compared to open surgery.
Area of Science:
- Oncology
- Surgical Oncology
- Endocrinology
Background:
- The efficacy of adrenalectomy (ADX) for adrenal metastasis remains unclear.
- Evaluating outcomes of ADX in patients with adrenal metastasis is crucial.
Purpose of the Study:
- To assess the outcomes of adrenalectomy in patients with adrenal metastasis.
- To compare laparoscopic adrenalectomy (LADX) with open adrenalectomy (ADX) for metastatic disease.
Main Methods:
- Retrospective analysis of 90 patients undergoing ADX for metastatic disease.
- Overall survival (OS) calculated using Kaplan-Meier method.
- Cox regression and Wilcoxon/Fisher's exact tests for factor associations.
Main Results:
- Melanoma and lung cancer were the most common primary sites.
- Median OS was 2.46 years; 5-year survival was 38%.
- Laparoscopic ADX showed reduced morbidity (operative time, blood loss, length of stay) without impacting OS or complications compared to open ADX.
Conclusions:
- ADX is a safe procedure for selected patients with adrenal metastasis.
- Prolonged survival is achievable for some patients post-ADX.
- Laparoscopic ADX is oncologically equivalent to open ADX, with significant benefits in minimizing patient morbidity.
