Percutaneous ablation for adrenal metastases: a systematic review and meta-analysis.

Abstract

Introduction: Imaging-guided percutaneous ablation (PA) is commonly employed for the treatment of patients diagnosed with adrenal metastasis (AM), but comprehensive analyses are essential to validate the efficacy and safety of this approach. Aim: The present meta-analysis was designed to evaluate the safety, efficacy, and long-term outcomes associated with the imaging-guided PA treatment of AM. Material and methods: Relevant studies in the PubMed, Embase, and Wanfang databases published as of June 2022 were identified, and pooled endpoint analyses were performed with Stata 12.0. Results: This meta-analysis included 15 studies. Overall, the respective pooled primary technical success, secondary technical success, local hemorrhage, pneumothorax, hypertension crisis, local recurrence, 1-year overall survival (OS), and 3-year OS rates in study participants were 88%, 93%, 3%, 6%, 6%, 19%, 80%, and 46%. High levels of heterogeneity were evident for the 1-year OS (I 2 = 79.6%) and 3-year OS endpoints (I 2 = 67.1%), but meta-regression analyses failed to identify predictors of these OS rates. Low heterogeneity was observed for subgroups of patients who had undergone cryoablation (I 2 = 0%) or patients with multiple primary cancers (I 2 = 0%) with respect to 1-year OS. Similarly, low heterogeneity for the 3-year OS endpoint was detected in subgroups of patients who had undergone cryoablation (I 2 = 0%), ultrasound-guided PA (I 2 = 0%), individuals with AMs secondary to hepatocellular carcinoma (I 2 = 0%), and patients with multiple primary cancers (I 2 = 0%).Conclusions: These results suggest imaging-guided PA to be a safe and effective treatment for AM associated with satisfactory long-term patient outcomes.

Percutaneous ablation for adrenal metastasis from non-small-cell lung cancer: comparison between cryoablation and microwave ablation

“…The adrenal glands are a major site of metastasis in patients with tumors of the lungs, liver, colon, kidneys, and other organs [1][2][3]. Non-small-cell lung cancer (NSCLC) is a highly prevalent primary tumor type often characterized by adrenal metastasis (AM), with NSCLC as the primary tumor type in 13-58% of AM patients [1,2].…”

“…Several reports, however, have indicated that adrenalectomy can improve AM patient overall survival (OS), with a post-surgery median OS of 23-30 months [5,6]. Together with the design of mini-invasive therapeutic techniques, imaging-guided ablation strategies have successfully been utilized to treat AM [2][3][4]. Liu et al [1] additionally determined that imaging-guided ablation and adrenalectomy can achieve comparable OS for AM lesions under 5 cm in size.…”