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Published on: February 12, 2017
Does resection of adrenal metastases from non-small cell lung cancer improve survival?
1Memorial Sloan Kettering Cancer Center, New York, New York 10021, USA.
Background:
Metastatic non-small cell lung cancer (NSCLC) carries a dismal prognosis, which is minimally affected by chemotherapy. Solitary brain metastases from NSCLC have been resected with 5-year survivals of 10% to 30%. The objective of this study was to determine if resection of isolated adrenal metastases improves survival.
Methods:
Isolated adrenal metastases were found in 14 patients with NSCLC. Eight patients had resection after cis-platinum-based chemotherapy, and 6 received chemotherapy alone.
Results:
Median survival in the surgical group was significantly greater than that in the chemotherapy group (31 versus 8.5 months; p = 0.03). All patients in the chemotherapy group were dead by 22 months. Three-year actuarial survival in the surgical group was 38%. No difference in locoregional stage, size of adrenal metastases, patient age, or performance status was present between the two groups.
Conclusions:
Long-term disease-free survival is possible after resection of isolated adrenal metastases from NSCLC. Resection of isolated adrenal metastases should be considered if the primary NSCLC is resectable.
Insights
Surgical resection of isolated adrenal metastases in non-small cell lung cancer (NSCLC) patients significantly improves survival compared to chemotherapy alone. This approach offers a chance for long-term disease-free survival.
Area of Science:
- Oncology
- Surgical Oncology
- Thoracic Surgery
Background:
- Metastatic non-small cell lung cancer (NSCLC) has a poor prognosis, with limited benefit from chemotherapy.
- Surgical resection of solitary brain metastases in NSCLC offers 5-year survival rates of 10-30%.
Purpose of the Study:
- To evaluate if surgical resection of isolated adrenal metastases improves survival in NSCLC patients.
Main Methods:
- A cohort of 14 NSCLC patients with isolated adrenal metastases was analyzed.
- Eight patients underwent resection after chemotherapy, while 6 received chemotherapy only.
Main Results:
- The median survival in the surgical group was 31 months, significantly longer than the 8.5 months in the chemotherapy-only group (p=0.03).
- Three-year actuarial survival was 38% in the surgical group; all chemotherapy-only patients died by 22 months.
- No significant differences in baseline characteristics (stage, metastasis size, age, performance status) were observed between groups.
Conclusions:
- Resection of isolated adrenal metastases can lead to long-term disease-free survival in NSCLC patients.
- Surgical intervention should be considered for isolated adrenal metastases when the primary NSCLC is resectable.
