SURGICAL TREATMENT OF SOLITARY ADRENAL METASTASIS FROM NON-SMALL CELL LUNG CANCER
https://doi.org/10.21294/1814-4861-2020-19-4-105-111
Abstract
Background. Adrenal glands are the site of solitary synchronous and metachronous metastases in non-small cell lung cancer (NSCLC). The presence of solitary adrenal metastasis from lung cancer provides survival benefit; however, currently, there are no exact treatment algorithms.
Objectives of the study: to assess shortand long-term treatment outcomes in patients with adrenal metastases from NSCLC.
Material and methods. Treatment outcomes of patients undergoing adrenalectomy for NSCLC were analyzed.
Results. From 1993 to 2014, 13 patients (11 males/2 females aged between 44 and 78, median age 58 years) with solitary adrenal metastases (adenocarcinoma (n=7), squamous cell carcinoma (n=4), large cell carcinoma (n=2); synchronous metastases – 5 cases (38.5%) and metachronous metastases – 8 cases (61.5 %), underwent adrenalectomy (one patient was given stereotactic radiation therapy for brain metastasis). Laparoscopic adrenalectomy was performed in 10 (76.9 %) cases, open adrenalectomy was performed in 3 (23.1 %) cases. The average adrenal tumor diameter was 74.6 ± 13.3 mm (25–170 mm). In the early postoperative period, two lethal outcomes were recorded. The median follow-up time after adrenalectomy was 20 months (3 to 267 months), the average follow-up time was 51.5 ± 23.5 months. The 3-year overall survival rates in patients with synchronous and metachronous metastases were 25.0 ± 2.2 % and 57.1 ± 1.9 %, respectively; however, the differences were not statistically significant (p=0.63; LogRank). The extent of surgery, morphological tumor type and status of regional lymph nodes produced no influence on the survival rate (p>0.05).
Conclusion. No factors influencing survival in patients with solitary adrenal metastases from NSCLC were identified.
Objectives of the study: to assess shortand long-term treatment outcomes in patients with adrenal metastases from NSCLC.
Material and methods. Treatment outcomes of patients undergoing adrenalectomy for NSCLC were analyzed.
Results. From 1993 to 2014, 13 patients (11 males/2 females aged between 44 and 78, median age 58 years) with solitary adrenal metastases (adenocarcinoma (n=7), squamous cell carcinoma (n=4), large cell carcinoma (n=2); synchronous metastases – 5 cases (38.5%) and metachronous metastases – 8 cases (61.5 %), underwent adrenalectomy (one patient was given stereotactic radiation therapy for brain metastasis). Laparoscopic adrenalectomy was performed in 10 (76.9 %) cases, open adrenalectomy was performed in 3 (23.1 %) cases. The average adrenal tumor diameter was 74.6 ± 13.3 mm (25–170 mm). In the early postoperative period, two lethal outcomes were recorded. The median follow-up time after adrenalectomy was 20 months (3 to 267 months), the average follow-up time was 51.5 ± 23.5 months. The 3-year overall survival rates in patients with synchronous and metachronous metastases were 25.0 ± 2.2 % and 57.1 ± 1.9 %, respectively; however, the differences were not statistically significant (p=0.63; LogRank). The extent of surgery, morphological tumor type and status of regional lymph nodes produced no influence on the survival rate (p>0.05).
Conclusion. No factors influencing survival in patients with solitary adrenal metastases from NSCLC were identified.
About the Authors
A. G. Muradyan
P.A. Gertsen Moscow Oncology Research Center – branch of the National Medical Research Radiological Center of the Ministry of Health of Russia;
Peoples’ Friendship University of Russia
Russian Federation
Russian Federation
Avetik G. Muradyan, MD, Postgraduate, Department of Urology and Nephrology With a Course of Urological Oncology; Oncologist
3, 2-nd Botkinsky proezd, 125284-Moscow;
6, Miklukho-Maklaya Street, 117198-Moscow
A. A. Kostin
Peoples’ Friendship University of Russia;
FSBI NMRRC of the Ministry of Health of the Russian Federation
Russian Federation
Russian Federation
Andrey A. Kostin, MD, Professor, Deputy Director
6, Miklukho-Maklaya Street, 117198-Moscow;
4, Koroleva Street, 249036-Obninsk
A. O. Tolkachev
P.A. Gertsen Moscow Oncology Research Center – branch of the National Medical Research Radiological Center of the Ministry of Health of Russia
Russian Federation
Russian Federation
Alexandr O. Tolkachev, MD, Researcher, Department of Urological Oncology
3, 2-nd Botkinsky proezd, 125284-Moscow
N. V. Vorobyev
P.A. Gertsen Moscow Oncology Research Center – branch of the National Medical Research Radiological Center of the Ministry of Health of Russia;
First Moscow State Medical University
Russian Federation
Russian Federation
Nikolai V. Vorobjev, MD, PhD, Head of Department of Urological Oncology
3, 2-nd Botkinsky proezd, 125284-Moscow;
8‑2, Trubetskaya Street, 119991-Moscow
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Review
For citations:
Muradyan A.G., Kostin A.A., Tolkachev A.O., Vorobyev N.V. SURGICAL TREATMENT OF SOLITARY ADRENAL METASTASIS FROM NON-SMALL CELL LUNG CANCER. Siberian journal of oncology. 2020;19(4):105-111. (In Russ.) https://doi.org/10.21294/1814-4861-2020-19-4-105-111
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