Management of suspected adrenal metastases at 2 academic medical centers

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• 作者：Jason A. Glenn ; M.D.^a ; Colleen M. Kiernan ; M.D.^b ; Tina W.F. Yen ; M.D. ; M.S.^a ; Carmen C. Solorzano ; M.D.^b ; Azadeh A. Carr ; M.D.^a ; Douglas B. Evans ; M.D.^a ; Tracy S. Wang ; M.D. ; M.P.H.^a ; ^{tswang@mcw.edu" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Adrenal metastasis ; Adrenalectomy ; Retroperitoneoscopic ; Adrenal biopsy
• 刊名：The American Journal of Surgery
• 出版年：2016
• 出版时间：April 2016
• 年：2016
• 卷：211
• 期：4
• 页码：664-670
• 全文大小：318 K

文摘

The optimal management of suspected adrenal metastases remains controversial.

Methods

This is a retrospective bi-institutional review of 37 patients who underwent adrenalectomy for suspected adrenal metastasis between 2001 and 2014.

Results

Three (8%) patients had benign adenomas on final pathology. At a median follow-up of 21 months, 7 (32%) patients were alive with no evidence of disease and 7 (32%) were alive with recurrent disease. Recurrence-free survival (RFS) was 8 months; decreased RFS was associated with positive margins and size ≥6 cm. Overall survival (OS) was 29 months; decreased OS was associated with capsular disruption. There were no differences in RFS or OS by surgical approach.

Conclusions

The favorable OS supports adrenalectomy in select patients with suspected adrenal metastases. Minimally invasive adrenalectomy is safe and effective, but the surgical approach should be based on the ability to achieve a margin-negative resection with avoidance of capsular disruption.