Survival following laparoscopic adrenalectomy for solitary metastasis of lung cancer

Int Urol Nephrol. 2016 Nov;48(11):1803-1809. doi: 10.1007/s11255-016-1368-y. Epub 2016 Jul 14.

Abstract

Purpose: To determine if L/S ADX is a safe and effective procedure for the management of solitary adrenal metastasis of lung cancer, and if it improves survival in lung cancer patients.

Materials and methods: The medical records of patients that were diagnosed as lung cancer and underwent L/S ADX for suspected adrenal gland metastasis were retrospectively analyzed. Patient demographics, prior interventions and medical treatments for lung cancer, adrenal mass characteristics, surgical features, postoperative course, and histopathological findings were examined.

Results: In total, 13 patients underwent 15 L/S ADXs due to suspected solitary adrenal metastasis of lung cancer. Mean age of the patients was 60.5 ± 7.3 years. Mean adrenal mass size based on CT was 35 ± 26.9 mm. The surgical margin was tumor-free in eight of the ADXs. Surgical margin positivity was observed in seven ADXs, and local recurrence was observed in only two patients (28.5 %) with surgical margin positivity. Mean estimated survival in the patients with metachronous adrenal metastasis was lower than in those with synchronous adrenal metastasis (33.1 ± 5.4 vs. 33.2 ± 7.5 months, respectively). Estimated survival in the patients with NSCLC was higher than in those with SCLC (33.9 ± 5.7 vs. 24 ± 4.2 months, respectively); the difference was not significant (P = 0.736). Estimated overall survival was 33.4 ± 5.2 months.

Conclusion: Resection of adrenal metastases of lung cancer via L/S ADX could be considered a viable method for achieving disease-free status and prolonging survival, especially in chemo-frayed patients.

Keywords: Adrenalectomy; Laparoscopy; Lung cancer; Metastasis; Survival.

MeSH terms

  • Adrenal Gland Neoplasms / pathology
  • Adrenal Gland Neoplasms / secondary
  • Adrenal Gland Neoplasms / surgery*
  • Adrenalectomy / methods*
  • Aged
  • Carcinoma, Non-Small-Cell Lung / pathology
  • Carcinoma, Non-Small-Cell Lung / secondary
  • Carcinoma, Non-Small-Cell Lung / surgery*
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Laparoscopy
  • Lung Neoplasms / pathology*
  • Male
  • Margins of Excision
  • Middle Aged
  • Neoplasm, Residual
  • Small Cell Lung Carcinoma / pathology
  • Small Cell Lung Carcinoma / secondary
  • Small Cell Lung Carcinoma / surgery*
  • Survival Rate
  • Tomography, X-Ray Computed
  • Tumor Burden