Surgical management of adrenal metastases from lung cancer

Beitler, Alan L.; Urschel, John D.; Velagapudi, Satish; Takita, Hiroshi

doi:10.1002/(sici)1096-9098(199809)69:1<54::aid-jso11>3.0.co;2-n

Cited by 72 publications

(51 citation statements)

References 24 publications

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“…In case of residual, subclinical tumor after LA, the less it is aggressive, the longer will be the postoperative DFI and the overall survival. The details of operative technique are of utmost importance to achieve a successful result, in that an incomplete resection is a cause of compromised survival (3,7). The limits of the dissection are the kidney, the diaphragmatic pilasters, the quadratus lumborum muscle, the cava vein on the right side, the pancreatic tail on the left.…”

Section: Discussionmentioning

confidence: 93%

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: Discussionmentioning

confidence: 93%

The role of laparoscopic resection of metastases to adrenal glands

et al. 2017

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“…(14). However, this finding appears inconsistent in relevant published literature (12,17), whereas many researchers did not include that variable in their analyses (8-11, 13, 16, 18, 19).…”

Section: Discussionmentioning

confidence: 99%

Surgical Management of Non-small Cell Lung Cancer with Solitary Hematogenous Metastases

Karagkiouzis

Spartalis²,

Moris

et al. 2017

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Abstract. Background Stage IV disease at initial presentation accounts for approximately 41% of newly-diagnosed cases with non-small cell lung cancer (NSCLC) (1). Prognosis for metastatic lung cancer remains dismal, despite continuously emerging treatment options. Although the majority of patients have disseminated metastatic disease at diagnosis, a small percentage are found to have a solitary metastasis. In addition any patients with NSCLC who previously received definitive treatment may experience metachronous solitary distant recurrence during the course of their disease. This poorly understood state of limited metastatic load has been described as oligometastatic disease and it seems to run a more indolent course (2, 3). Retrospective clinical studies focused on the surgical management of solitary extrapulmonary metastases, have reported favorable results (4).The aim of this retrospective study was to review our experience with patients who underwent resection of primary NSCLC and solitary extrapulmonary metastasis, and to analyze prognostic factors affecting survival. Patients and MethodsWe reviewed the medical records of thoracic surgical Departments at Laikon General Hospital of Athens and Sotiria Hospital for Chest Diseases (former Second Department of Thoracic Surgery) from January 2004 to December 2012 for patients with NSCLC having undergone combined resections (including stereotactic radiosurgery) of primary lung tumor and solitary hematogenous metastasis.

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“…35 Three of these four papers were restricted to surgical results in lung cancer, [48][49][50] with Gunjur and colleagues analyzing surgery (n=30 studies) and ablative RT (n=9) for adrenal OM from all primary tumor sites. 35 Gunjur et al reported a weighted 2-year OS of 46% for adrenalectomy versus 19% for SBRT, and 2-year local control (LC) of 84% versus 63% respectively.…”

Section: Discussionmentioning

confidence: 99%

Adrenal Oligometastases Secondary to Non-small Cell Lung Cancer—What is the Optimal Treatment Approach?

Thomsen¹,

Fairchild²

2017

Oncology &Amp; Hematology Review (US)

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B ackground: Five-year overall survival (OS) for patients with stage IV non-small cell lung cancer (NSCLC) is a dismal 1%. However, approximately 7% have limited or solitary metastases, including to the adrenal gland. Radical treatment of these oligometastases (OM) could increase local control and improve OS. Our objective was to critically analyze data describing aggressive treatment of adrenal OM secondary to NSCLC. Methods: A literature search examining English publications describing surgery or radiotherapy (RT) was performed, supplemented by searching reference lists. Case reports of three or fewer patients, and articles from which NSCLC-or adrenal-specific clinical outcomes could not be abstracted, were excluded. Results: Twenty-nine studies met eligibility criteria (521 patients), 26 retrospective. No publications directly compare modalities. Four surgery studies described contemporaneous patients treated with palliative chemotherapy (CH) alone. Reported median OS ranged from 9.5-64 months after adrenalectomy, 8-23 months after RT, and 6-8.5 months after CH. Local failure after surgery was 14%, with response rates after RT 57-75%. Both appear well-tolerated. Conclusions: In patients with an adrenal OM secondary to NSCLC, aggressive treatment should be considered. However, due to the paucity of high quality evidence, it is unclear at present whether this approach alters the natural history of the disease.

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Surgical management of adrenal metastases from lung cancer

Cited by 72 publications

References 24 publications

The role of laparoscopic resection of metastases to adrenal glands

The role of laparoscopic resection of metastases to adrenal glands

Surgical Management of Non-small Cell Lung Cancer with Solitary Hematogenous Metastases

Adrenal Oligometastases Secondary to Non-small Cell Lung Cancer—What is the Optimal Treatment Approach?

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