Frederick Thurston Drake1, Toni Beninato2, Maggie X Xiong3, Nirav V Shah3, Wouter P Kluijfhout3, Timothy Feeney4, Insoo Suh3, Jessica E Gosnell3, Wen T Shen3, Quan-Yang Duh3. 1. Division of Endocrine Surgery, Department of Surgery, University of California, San Francisco, CA; Section of Surgical Oncology, Department of Surgery, Boston University School of Medicine, MA. Electronic address: ftdrake@bu.edu. 2. Division of Endocrine Surgery, Department of Surgery, University of California, San Francisco, CA; Division of Endocrine Surgery, Department of Surgery, Weill Cornell Medicine, New York, NY. 3. Division of Endocrine Surgery, Department of Surgery, University of California, San Francisco, CA. 4. Section of Surgical Oncology, Department of Surgery, Boston University School of Medicine, MA.
Abstract
BACKGROUND: Several malignancies metastasize to the adrenal gland, especially non-small cell lung cancer, renal cell carcinoma, and melanoma. Adrenalectomy is associated with prolonged survival, but laparoscopic adrenalectomy for this indication is controversial. Our objective was to characterize and quantify outcomes after laparoscopic adrenalectomy for metastases to the adrenal gland. METHODS: A prospectively maintained surgical database and institutional cancer registry were queried for patients who underwent adrenalectomy for metastases. From 1995 to 2016, a total of 62 patients underwent adrenalectomy for metastases, with 59 (95.%) having been performed laparoscopically. Primary end points were cumulative probability of 5-year survival and median survival. Patients in the institutional series were compared with Surveillance, Epidemiology, and End Results patients with metastatic non-small cell lung cancer, renal cell carcinoma, and melanoma. RESULTS: There were no deaths within a 30-day period, 6 complications, and 2 conversions to open adrenalectomy. Non-small cell lung cancer (N = 20), renal cell carcinoma (N = 14), and melanoma (N = 8) were the 3 most common adrenal metastases. Overall, cumulative probability of 5-year survival was 37% and median survival was 34 months (95% CI 26-53 months). Median survival for non-small cell lung cancer was 26 months, for renal cell carcinoma was 67 months, and for melanoma was 30 months (P = NS). There was no demonstrable survival benefit for metachronous versus synchronous presentations, no association with size or disease-free interval, nor the presence/history of other metastases. CONCLUSION: Laparoscopic adrenalectomy for metastases is safe when performed by experienced surgeons. Outcomes are similar or improved compared with series with predominantly open adrenalectomies. Patients selected for laparoscopic adrenalectomy to treat metastatic disease also have prolonged survival compared with Surveillance, Epidemiology, and End Results patients with metastatic non-small cell lung cancer, renal cell carcinoma, or melanoma who do not undergo resection of metastatic disease.
BACKGROUND: Several malignancies metastasize to the adrenal gland, especially non-small cell lung cancer, renal cell carcinoma, and melanoma. Adrenalectomy is associated with prolonged survival, but laparoscopic adrenalectomy for this indication is controversial. Our objective was to characterize and quantify outcomes after laparoscopic adrenalectomy for metastases to the adrenal gland. METHODS: A prospectively maintained surgical database and institutional cancer registry were queried for patients who underwent adrenalectomy for metastases. From 1995 to 2016, a total of 62 patients underwent adrenalectomy for metastases, with 59 (95.%) having been performed laparoscopically. Primary end points were cumulative probability of 5-year survival and median survival. Patients in the institutional series were compared with Surveillance, Epidemiology, and End Results patients with metastatic non-small cell lung cancer, renal cell carcinoma, and melanoma. RESULTS: There were no deaths within a 30-day period, 6 complications, and 2 conversions to open adrenalectomy. Non-small cell lung cancer (N = 20), renal cell carcinoma (N = 14), and melanoma (N = 8) were the 3 most common adrenal metastases. Overall, cumulative probability of 5-year survival was 37% and median survival was 34 months (95% CI 26-53 months). Median survival for non-small cell lung cancer was 26 months, for renal cell carcinoma was 67 months, and for melanoma was 30 months (P = NS). There was no demonstrable survival benefit for metachronous versus synchronous presentations, no association with size or disease-free interval, nor the presence/history of other metastases. CONCLUSION: Laparoscopic adrenalectomy for metastases is safe when performed by experienced surgeons. Outcomes are similar or improved compared with series with predominantly open adrenalectomies. Patients selected for laparoscopic adrenalectomy to treat metastatic disease also have prolonged survival compared with Surveillance, Epidemiology, and End Results patients with metastatic non-small cell lung cancer, renal cell carcinoma, or melanoma who do not undergo resection of metastatic disease.
Authors: Laila König; Matthias F Häfner; Sonja Katayama; Stefan A Koerber; Eric Tonndorf-Martini; Denise Bernhardt; Bastian von Nettelbladt; Fabian Weykamp; Philipp Hoegen; Sebastian Klüter; Matthew S Susko; Jürgen Debus; Juliane Hörner-Rieber Journal: Radiat Oncol Date: 2020-02-04 Impact factor: 3.481
Authors: Madelon J H Metman; Charlotte L Viëtor; Auke J Seinen; Annika M A Berends; Patrick H J Hemmer; Michiel N Kerstens; Richard A Feelders; Gaston J H Franssen; Tessa M van Ginhoven; Schelto Kruijff Journal: Cancers (Basel) Date: 2021-12-29 Impact factor: 6.639