Survival After Adrenalectomy for Metastatic Lung Cancer

Area of Science:

• Oncology
• Surgical Oncology
• Thoracic Surgery

Background:

• Adrenal metastasectomy improves survival in non-small cell lung cancer (NSCLC) with isolated adrenal metastases.
• Current indications for adrenal metastasectomy are not well-defined.
• This study evaluates the clinical benefit of adrenal metastasectomy across all lung cancer subtypes.

Purpose of the Study:

• To assess the clinical benefit of adrenal metastasectomy for patients with metastatic lung cancer.
• To identify factors influencing disease-free survival (DFS) and overall survival (OS) after adrenal metastasectomy.

Main Methods:

• Retrospective cohort study of 122 patients undergoing adrenal metastasectomy for metastatic lung cancer (2001-2015).
• Primary outcomes: disease-free survival (DFS) and overall survival (OS).
• Statistical analyses included Cox proportional hazards regressions and Kaplan-Meier survival analysis.

Main Results:

• Median DFS was 40 months; median OS was 47 months.
• Factors associated with longer DFS: primary tumor resection, longer time to metastasis, and ipsilateral metastases.
• Factors associated with longer OS: ipsilateral metastasis and adjuvant chemotherapy. Small cell histology and extra-adrenal metastases were associated with shorter OS.

Conclusions:

• Adrenal metastasectomy can lead to durable survival and should be considered for isolated adrenal metastases in NSCLC.
• Small cell lung cancer histology and the presence of extra-adrenal metastases are relative contraindications for adrenal metastasectomy.