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Rivista di Chirurgia
Indexed/Abstracted in: EMBASE, Scopus, Emerging Sources Citation Index
Chirurgia 2015 Aprile;28(2):63-7
The role of adrenalectomy for solitary adrenal metastases from non-small cell lung cancer
Huang S., Li Y., Chen H., Wu W., An J., Zhang J.
Department of Cardiothoracic Surgery, Third Affiliated Hospital, Sun Yat‑Sen University, Guangzhou, China
AIM: To examine the survival of patients with non-small cell lung cancer (NSCLC) and solitary adrenal metastasis that underwent adrenalectomy (ADX), in comparison with the survival of those treated nonoperatively. To investigate potential prognostic factors for survival among these patients.
METHODS: Retrospective review of inpatient records from 2001 to 2010 were identified 26 patients with NSCLC and solitary adrenal metastasis. Log-rank tests were used to compare the overall survival of patients who underwent both primary resection and ADX and that of patients who were treated conservatively. Clinical, therapeutic, pathologic, primary, and metastatic characteristics were evaluated as potential prognostic factors using univariate and multivariate analyses.
RESULTS: Among patients with NSCLC patients and solitary adrenal metastasis, the median overall survival was 11 months (95% confidence interval [CI], 9.4-12.6 months), and the 1-year survival rate was 51.4% (95% CI, 29.6-73.2%). No significant survival difference was observed between patients who underwent primary and metastasis resection (N.=10) and those treated conservatively (N.=12; P=0.209). Univariate analyses identified Eastern Cooperative Oncology Group performance status (ECOG PS) as the only risk factor for death (P=0.024). A stepwise multivariate Cox analysis retained only ECOG PS (P=0.007; RR=3.57) and pathologic type (P=0.069) in the final model.
CONCLUSION: ECOG PS and histology may be the principal prognostic factors for NSCLC with solitary adrenal metastasis. Primary and metastatic radical resection did not extend the survival of patients with ECOG PS of 3 or N2 disease.