title: [Bilateral adrenalectomy for advanced breastcarcinoma (author's transl)].
abstract: Two hundred and seventy-one consecutive charts of all patients who underwent a bilateral adrenalectomy from 1955 till 1974 were studied. Of those 267 could be retained for this study. The operation was performed through a bilateral subdiaphragmatic or transabdominal approach. The postoperative corticosteroid substitution therapy did not pose grave problems. A remission was obtained in 36.2% of all cases (average 18 months, median 10 months with 4% 5 years later. The mortality was 20.7% and is the exponent of an aggressive approach with few criteria for exclusion from surgery. Massive liver and neurons system metastases were contra-indications for surgery. When a remission the survival attained 24.7 months with a median of 20 months and 8% at 5 years. A few survived much longer. Presently, the bilateral adrenalectomy, a major procedure, should be reserved for those women with a hormone dependent tumor. Criteria are the study of the hormone receptors or the observation of a prior remission after a premenopausal oophorectomy. A multi-disciplinary approach including several types of chemotherapy can be applied to those patients for whom surgery is contraindicated. (Acta chir. belg., 1981, 80, 1-9).
mesh_terms: D000315:Adrenalectomy; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000401:mortality / Q000628:therapy*; D005260:Female; D006801:Humans; D008593:Menopause; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies
chemical_list: D000970:Antineoplastic Agents
vernacular_title: La surrénalectomie bilatérale dans le cancer du sein en phase avancée. Résultats et place dans la politique de traitement.