Prognostic Parameters after Surgery for Adrenal Metastases: a Single Institution Experience

Background: Clinically isolated adrenal metastases are rare and therefore present a therapeutic challenge. We report our experience with surgery of adrenal metastases and analyze factors that may influence postoperative survival. Methods: A consecutive series of 31 patients (16 male, 15 female) unde...

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Published in:Acta chirurgica belgica 2014-05, Vol.114 (3), p.198-202
Main Authors: Paunovic·, I., Zivaljevic, V., Diklic, A., Tausanovic, K., Stojanic, R., Sipetic, S.
Format: Article
Language:English
Subjects:
Adrenal Gland Neoplasms - mortality
Adrenal Gland Neoplasms - secondary
Adrenal Gland Neoplasms - therapy
Adrenalectomy
Adult
Aged
Breast Neoplasms - pathology
Carcinoma - mortality
Carcinoma - pathology
Carcinoma - secondary
Carcinoma - therapy
Colorectal Neoplasms - pathology
Female
Humans
Kidney Neoplasms - pathology
Lung Neoplasms - pathology
Male
Melanoma - mortality
Melanoma - pathology
Melanoma - secondary
Melanoma - therapy
Middle Aged
Multivariate Analysis
Prognosis
Radiotherapy, Adjuvant
Skin Neoplasms - pathology
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Summary:Background: Clinically isolated adrenal metastases are rare and therefore present a therapeutic challenge. We report our experience with surgery of adrenal metastases and analyze factors that may influence postoperative survival. Methods: A consecutive series of 31 patients (16 male, 15 female) underwent adrenal surgery for metastases at a single institution over 10-year period (1999-2008). The Kaplan-Meier method and log-rank test were used to determine overall survival. Potential prognostic factors were identified by univariate and multivariate Cox regression analysis. Results: The primary tumor diagnoses were non-small-cell lung carcinoma (NSCLC) 20, colorectal carcinoma 5, renal cell carcinoma (RCC) 2, malignant melanoma and breast carcinoma, one each. The median survival was 12 months, with one year and five year survival of 21% and 3.4% respectively. According to multivariate analysis independent prognostic factors of favorable survival were disease free interval (DFI) longer than 12 months (Hazard ratio (HR) = 0.28, 95%CI = 0.09-0.90), potentially curative resection (Hazard ratio (HR) = 0.35, 95%CI = 0.12-1.00) and postoperative radiotherapy of adrenal bed (Hazard ratio (HR) = 0.33, 95%CI = 0.12-0.91). Conclusions: Overall survival after surgery for adrenal metastases is poor. In multivariate analyses, survival is influenced by DFI, curative resection, and postoperative radiotherapy.
ISSN:0001-5458
DOI:10.1080/00015458.2014.11681008