Long-term outcome in patients with adrenal metastases following resection of colorectal liver metastases

Background: The prognostic significance of adrenal metastases (AMs) in patients with colorectal liver metastases (CLMs) remains unknown. The aim of this study was to determine the influence of AMs on long‐term outcome and the role of adrenalectomy in patients with CLMs. Methods: All patients resecte...

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Bibliographic Details
Published in:British journal of surgery 2009-08, Vol.96 (8), p.935-940
Main Authors: de Haas, R. J., Rahy Martin, A. C., Wicherts, D. A., Azoulay, D., Castaing, D., Adam, R.
Format: Article
Language:English
Subjects:
Adrenal Gland Neoplasms - secondary
Adrenal Gland Neoplasms - surgery
Adrenalectomy - mortality
Biological and medical sciences
Colorectal Neoplasms
Female
Gastroenterology. Liver. Pancreas. Abdomen
General aspects
Hepatectomy - mortality
Humans
Liver Neoplasms - secondary
Liver Neoplasms - surgery
Liver. Biliary tract. Portal circulation. Exocrine pancreas
Male
Medical sciences
Middle Aged
Treatment Outcome
Tumors
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Summary:Background: The prognostic significance of adrenal metastases (AMs) in patients with colorectal liver metastases (CLMs) remains unknown. The aim of this study was to determine the influence of AMs on long‐term outcome and the role of adrenalectomy in patients with CLMs. Methods: All patients resected for CLMs who developed AMs at a single institution between 1992 and 2006 were included in the study. Their long‐term outcome was compared with that of all other patients resected for CLMs but without AMs. Results: Hepatectomy was performed in 796 patients, of whom 14 (1·8 per cent) developed AMs, a median of 28 months after initial diagnosis of CLMs; the remaining 782 patients (98·2 per cent) had no AMs. All 14 patients had chemotherapy, and ten went on to adrenalectomy. Median survival after diagnosis of CLMs was 50 months in patients with AMs versus 68 months in those without (P = 0·020). After diagnosis of AMs, median survival was 23 months, whether or not adrenalectomy was performed. Conclusion: The development of AMs after liver resection for colorectal cancer deposits carries a poor prognosis, and adrenalectomy is probably not warranted. Copyright © 2009 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. Adrenalectomy of limited benefit
ISSN:0007-1323
1365-2168
DOI:10.1002/bjs.6646