Laparoscopic Adrenalectomy for Isolated Adrenal Metastasis

Strong, Vivian E.; D’Angelica, Michael I.; Tang, Longwen; Prete, F.; Gönen, Mithat; Coit, Daniel G.; Touijer, Karim; Fong, Yuman; Brennan, Murray F.

doi:10.1245/s10434-007-9520-7

Cited by 196 publications

(164 citation statements)

References 18 publications

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“…The mathematical model introduced with the stepwise regression (backward procedure) considering the three chosen independent variables together (diameter of the metastasis and pre-adrenalectomy DFI, suggested by the literature as independent factors of prolonged survival (3)(4)(5), and post-adrenalectomy DFI, individuated by the univariate analysis as the factor mostly related to survival in our sample ) was not significant (P=n.s.). Then at step1 the model excluded the less significant variable (diameter of the metastasis), and the new p value for the remaining two was: P=0.04.…”

Section: Resultsmentioning

confidence: 75%

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The role of laparoscopic resection of metastases to adrenal glands

et al. 2017

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Background: The potential role of the laparoscopic approach for metastases to the adrenal gland is debated. We review here a series of patients consecutively submitted to laparoscopic adrenalectomy (LA) for suspected adrenal metastasis (AM).Methods: Retrospective study (consecutive series) of LA for AM. We measured parameters associated to primary tumor and metastasis. Statistical analysis: stepwise regression model.Results: Thirty-seven LA were performed on 36 patients. The mean age was 62.1 yrs. The side was right in 13 cases. Primary tumor was in the lung (n=22), breast (n=4), colon-rectum (n=4), kidney (n=3), thyroid, melanoma and ovary (n=1 each). Thirty-three out of 37 were confirmed to be AM (mean diameter 50 mm).Twenty-five were single metastasis. One LA was converted due to cava vein infiltration. Mean operative time was 142 min', median p.o. hospital stay was 3 days. After a mean follow-up of 33 months, 9 patients (25%) were alive free of disease, 6 (17%) were alive with disease. Mean post-adrenalectomy DFI was 19 months (range, 0-97 months), and it was the most predictive variable for survival (P<0.001). Conclusions:The dimensions and absence of invasion on imaging, the evolutive status of the disease and the performance status of the patient are key factors for LA, which is associated with adequate oncologic results, a quicker postoperative recovery, and potential survival benefits.

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Section: Resultsmentioning

confidence: 75%

“…When compared to open adrenalectomy, LA for AM results in less morbidity (including pain), shorter hospital stay, quicker recovery and better cosmetic results (that is all the benefits of laparoscopic approach), with the same oncologic outcomes (2,5,26,29,30).…”

Section: Discussionmentioning

confidence: 99%

The role of laparoscopic resection of metastases to adrenal glands

et al. 2017

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“…Laparoscopic adrenalectomy has been shown to improve patients' morbidity and to reduce hospitalization with a comparative oncological outcome compared to the open resection technique. 13 However, laparoscopic procedures are contraindicated in lesions larger than 6 cm. 14 Overall, the rate of major complication after surgery is around 1.8%.…”

Section: Introductionmentioning

confidence: 99%

SBRT: A viable option for treating adrenal gland metastases

Ippolito

D’Angelillo

Fiore

et al. 2015

Reports of Practical Oncology & Radiotherapy

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a b s t r a c tThe management strategy of adrenal metastases depends on different clinical situations.Adrenal metastasectomy in selected patients with isolated adrenal metastases is considered the treatment of choice, showing prolonged survival compared to chemotherapy alone.More recently, Stereotactic Body Radiation Therapy (SBRT) has emerged as an alternative local ablative treatment modality although limited data are available on the use of SBRT in treating adrenal gland metastases. Preliminary results are, however, encouraging, especially in selected patients with oligometastatic disease. We herewith review and discuss the potential role of SBRT as a local ablative treatment modality for adrenal metastases.

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“…Long-term survival rates have been reported in patients after adrenalectomy due to metastatic disease, provided there was an isolated metastasis [3,[11][12][13]. In terms of surgical approach, numerous authors have reported safety and similar oncological results of laparoscopic adrenalectomy for metastases compared to open surgery [11,12,[14][15][16]. In the present study, we have presented our clinical results from the endoscopic removal of suspected adrenal metastases, and have tried to evaluate the significance of certain clinical and pathological parameters for prediction of long-term survival after adrenalectomy.…”

Section: Introductionmentioning

confidence: 99%

Adrenalectomy for Isolated Metastases

Shumarova¹,

Petrov²,

Grozdev³

et al. 2017

JofIMAB

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Background: Isolated adrenal gland metastases are not frequently finding. The aim of the present retrospective study was to estimate clinical and pathological parameters that could be used to predict survival after adrenalectomy.Material and methods: A total of 34 patients with adrenal gland masses suspected to be metastases was included in this study. The group of patients with isolated metastases was19 (56%) and a group of patients with adrenal adenomas -15 (44%).Results: The sample of patients consisted of 18 (53%) men and 16 (47%) women from 40 to 81 years old with a mean (±SD) age of 61.6±10.3 years, presented with adrenal mass suspected to be metastases. Nineteen (56%) of them had demonstrated metastases and 16 (84%) metachronous with median overall survival (OS) 54.6 (range 43-66) months. Median OS in the group with metastases was 22.6 months. Lung carcinoma was the most common primary tumour metastasizing in the adrenal gland -58% of all metastases with a disease-free interval (DFI) of 13 months. It was presented by shorter median survival than the rest primary tumour types (37.8 vs. 96.7months; logrank test, p=0.028). In the multivariate Cox's hazard analysis of the surgical technique was found to be an independent prognostic factor (p=0.047), together with lung carcinoma vs. renal cell carcinoma (p=0.045).Conclusion: Adrenalectomy due to isolated metastases in the adrenal glands showed the median overall survival of 22.6 months. Shorter survival periods were associated with lung carcinoma, DFI<12months, conversion to open surgery, synchronous metastases, but not with age, tumour size or resection status.

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Laparoscopic Adrenalectomy for Isolated Adrenal Metastasis

Cited by 196 publications

References 18 publications

The role of laparoscopic resection of metastases to adrenal glands

The role of laparoscopic resection of metastases to adrenal glands

SBRT: A viable option for treating adrenal gland metastases

Adrenalectomy for Isolated Metastases

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