Management of suspected adrenal metastases at 2 academic medical centers

Abstract Background The optimal management of suspected adrenal metastases remains controversial. Methods This is a retrospective bi-institutional review of 37 patients who underwent adrenalectomy for suspected adrenal metastasis between 2001 and 2014. Results Three (8%) patients had benign adenomas...

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Published inThe American journal of surgery Vol. 211; no. 4; pp. 664 - 670
Main Authors Glenn, Jason A., M.D, Kiernan, Colleen M., M.D, Yen, Tina W.F., M.D., M.S, Solorzano, Carmen C., M.D, Carr, Azadeh A., M.D, Evans, Douglas B., M.D, Wang, Tracy S., M.D., M.P.H
Format Journal Article
LanguageEnglish
Published United States Elsevier Inc 01.04.2016
Elsevier Limited
Subjects
Abdomen
Academic Medical Centers
Adrenal biopsy
Adrenal Gland Neoplasms - secondary
Adrenal Gland Neoplasms - surgery
Adrenal glands
Adrenal metastasis
Adrenalectomy
Aged
Body mass index
Breast cancer
Cancer therapies
Chemotherapy
Diagnostic Imaging
Family medical history
Female
Habitus
Humans
Image-Guided Biopsy
Laparoscopy
Male
Medical imaging
Melanoma
Metastasis
Middle Aged
Neoplasm Recurrence, Local
Neoplasm Staging
Retroperitoneoscopic
Retrospective Studies
Studies
Surgery
Survival Rate
Treatment Outcome
Tumors
Adrenalectomy
Adrenal metastasis
Retroperitoneoscopic
Adrenal biopsy
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Summary:Abstract Background The optimal management of suspected adrenal metastases remains controversial. Methods This is a retrospective bi-institutional review of 37 patients who underwent adrenalectomy for suspected adrenal metastasis between 2001 and 2014. Results Three (8%) patients had benign adenomas on final pathology. At a median follow-up of 21 months, 7 (32%) patients were alive with no evidence of disease and 7 (32%) were alive with recurrent disease. Recurrence-free survival (RFS) was 8 months; decreased RFS was associated with positive margins and size ≥6 cm. Overall survival (OS) was 29 months; decreased OS was associated with capsular disruption. There were no differences in RFS or OS by surgical approach. Conclusions The favorable OS supports adrenalectomy in select patients with suspected adrenal metastases. Minimally invasive adrenalectomy is safe and effective, but the surgical approach should be based on the ability to achieve a margin-negative resection with avoidance of capsular disruption.
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ISSN:0002-9610
1879-1883
DOI:10.1016/j.amjsurg.2015.11.019