Survival outcomes following adrenalectomy for isolated metastases to the adrenal gland

Ramsingh, Jason; O’Dwyer, P. J.; Watson, Carol

doi:10.1016/j.ejso.2019.01.006

Cited by 10 publications

(10 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…We did not examine the relationship of adrenalectomy to the burden of disease or the presence of other extra‐adrenal metastases. As previously reported in patients with primary renal cell cancer, nephrectomy and concomitant intraoperative adrenalectomy in the setting of a known solitary intra‐adrenal lesion was associated with improved prognosis 16,17 . Lam and Lo also reported that aggressive surgical resection of adrenal metastases (as well as other involved sites) was associated with improved survival outcomes overall 14 .…”

Section: Discussionsupporting

confidence: 54%

“…As previously reported in patients with primary renal cell cancer, nephrectomy and concomitant intraoperative adrenalectomy in the setting of a known solitary intra-adrenal lesion was associated with improved prognosis. 16,17 Lam and Lo also reported that aggressive surgical resection of adrenal metastases (as well as other involved sites) was associated with improved survival outcomes overall. 14 Additionally, a recent systematic review on therapeutic interventions for adrenal metastases that had excluded cases with ipsilateral synchronous renal cell carcinoma showed that the 2-year survival of patients who underwent adrenalectomy for adrenal metastases was Primary adrenal insufficiency was diagnosed either biochemically (elevated adrenocorticotropic hormone, low cortisol or abnormal cosyntropin stimulation test) or upon clinical suspicion in the setting of bilateral adrenal metastases (i.e.…”

Section: Bilateral Disease and Adrenal Insufficiencymentioning

confidence: 97%

“…14 This discrepancy may be explained by selection bias, as the previous study included mostly patients diagnosed postmortem, which likely skewed the distribution towards cases with worse prognoses. 14 As patients with certain metastatic GU cancers (ie renal cell carcinoma) present with a far more favourable prognosis if only a solitary intra-adrenal lesion exists as the extent of disease, 16,17 it is likely that fewer cases of GU primaries were included in the former study.…”

Section: Bilateral Disease and Adrenal Insufficiencymentioning

confidence: 99%

See 2 more Smart Citations

Presentation, disease progression and outcomes of adrenal gland metastases

Mao

Dages

Suresh

et al. 2020

Clinical Endocrinology

View full text Add to dashboard Cite

Objective: Data on the presentations and outcomes of patients with adrenal gland metastases are limited. Our objectives were to characterize the prevalence of adrenal metastases subtypes and investigate how varying clinical presentations affect disease progression, development of primary adrenal insufficiency (PAI) and mortality. Design: Single institution tertiary centre, retrospective cohort study from 1997 to 2020. Patients and Measurements: Adult patients with adrenal metastases. Clinical, radiologic and biochemical presentations and outcomes were reviewed. Results: Of 579 patients (62.3% men, median age 67 years [range 25-92]) with adrenal metastases (median tumour size of 30 mm [range 5-200]), 339 (58.5%) were discovered during cancer staging, 210 (36.3%) were found incidentally, and 29 (5.0%) based on symptoms. Tumours originated from the lung (226, 39.0%), genitourinary (GU) (160, 27.6%), gastrointestinal (GI) (79, 13.6%) and other (114, 19.7%) organ systems. Bilateral metastases were found in 140 (24.2%) patients at the time of initial diagnosis, and 249 (43.0%) had bilateral disease throughout the study course. PAI developed in 12.4% of patients with bilateral disease and was associated with larger tumour size. Median follow-up time was 14 months (range 0-232), and 442 (76.3%) patients died. Higher mortality was independently associated with older age, adrenal metastases originating from the lung, bilateral disease, and the absence of adrenalectomy. Conclusions: Adrenal gland metastases originated most commonly from lung, GU and GI malignancies. Bilateral adrenal metastases occurred in 43% of patients, and PAI occurred in 12.4% of those with bilateral disease, warranting further case detection strategies.

show abstract

Section: Discussionsupporting

confidence: 54%

Section: Bilateral Disease and Adrenal Insufficiencymentioning

confidence: 97%

Section: Bilateral Disease and Adrenal Insufficiencymentioning

confidence: 99%

See 1 more Smart Citation

Presentation, disease progression and outcomes of adrenal gland metastases

Mao

Dages

Suresh

et al. 2020

Clinical Endocrinology

View full text Add to dashboard Cite

show abstract

“…Lung cancer as the origin of the metastasis seems to be concordant with the literature. However, colorectal cancer has not previously been described as one of the most common origins [ 23 , 24 , 25 , 26 ]. A possible reason for the found percentage of primary colorectal cancers could be explained by the fact that the Netherlands has one of the highest incidences of colorectal cancer worldwide [ 27 ].…”

Section: Discussionmentioning

confidence: 99%

Outcomes after Surgical Treatment of Metastatic Disease in the Adrenal Gland; Valuable for the Patient?

Metman

Viëtor

Seinen

et al. 2021

Cancers

View full text Add to dashboard Cite

The adrenal glands are common dissemination sites for metastasis of various solid tumors. Surgical treatment is often recommended because targeted therapies and immunotherapy are frequently ineffective for adrenal metastasis. We report the experience with short-term and long-term surgical outcomes of patients undergoing surgery for adrenal metastasis in two hospitals. A retrospective, multicenter study was performed to analyze patient characteristics, tumor-related data, perioperative outcomes, and oncological outcomes. Postoperative complications that occurred within 30 days were scored according to the Clavien Dindo classification. Metastatic adrenalectomy was performed in 95 patients. We observed an increase from an average of 3 metastatic adrenalectomies per year between 2001–2005 to 10 between 2015–2019. The most frequent underlying malignancies were colorectal and lung cancer. In 55.8%, minimal invasive adrenalectomy was performed, including six conversions to open surgery. A total of 37.9% of patients had postoperative complications, of which ileus or gastroparesis, wound problems, pneumonia, and heart arrhythmias were the most occurring complications. Improved cancer care has led to an increased demand for metastatic adrenalectomy over the past years. Complication rates of 37.9% are significant and cannot be neglected. Therefore, multidisciplinary teams should weigh the decision to perform metastatic adrenalectomy for each patient individually, taking into account the drawbacks of the described morbidity versus the potential benefits.

show abstract

“…Since the first description of adrenalectomy for isolated metastasis in 1982 [18], many retrospective series showed a potential benefit in survival in well-selected patients undergoing surgical treatment [19][20][21][22][23][24][25][26].…”

Section: Case Presentationmentioning

confidence: 99%