J D Luketich1, M E Burt. 1. Memorial Sloan Kettering Cancer Center, New York, New York 10021, USA.
Abstract
BACKGROUND: Metastatic non-small cell lung cancer (NSCLC) carries a dismal prognosis, which is minimally affected by chemotherapy. Solitary brain metastases from NSCLC have been resected with 5-year survivals of 10% to 30%. The objective of this study was to determine if resection of isolated adrenal metastases improves survival. METHODS: Isolated adrenal metastases were found in 14 patients with NSCLC. Eight patients had resection after cis-platinum-based chemotherapy, and 6 received chemotherapy alone. RESULTS: Median survival in the surgical group was significantly greater than that in the chemotherapy group (31 versus 8.5 months; p = 0.03). All patients in the chemotherapy group were dead by 22 months. Three-year actuarial survival in the surgical group was 38%. No difference in locoregional stage, size of adrenal metastases, patient age, or performance status was present between the two groups. CONCLUSIONS: Long-term disease-free survival is possible after resection of isolated adrenal metastases from NSCLC. Resection of isolated adrenal metastases should be considered if the primary NSCLC is resectable.
BACKGROUND: Metastatic non-small cell lung cancer (NSCLC) carries a dismal prognosis, which is minimally affected by chemotherapy. Solitary brain metastases from NSCLC have been resected with 5-year survivals of 10% to 30%. The objective of this study was to determine if resection of isolated adrenal metastases improves survival. METHODS: Isolated adrenal metastases were found in 14 patients with NSCLC. Eight patients had resection after cis-platinum-based chemotherapy, and 6 received chemotherapy alone. RESULTS: Median survival in the surgical group was significantly greater than that in the chemotherapy group (31 versus 8.5 months; p = 0.03). All patients in the chemotherapy group were dead by 22 months. Three-year actuarial survival in the surgical group was 38%. No difference in locoregional stage, size of adrenal metastases, patient age, or performance status was present between the two groups. CONCLUSIONS: Long-term disease-free survival is possible after resection of isolated adrenal metastases from NSCLC. Resection of isolated adrenal metastases should be considered if the primary NSCLC is resectable.
Authors: I Hornstein; C Schwarz; S Ebbing; M Hoppe-Lotichius; G Otto; H Lang; T J Musholt Journal: Langenbecks Arch Surg Date: 2015-03-01 Impact factor: 3.445
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