title: Factors influencing adrenal metastasis in renal cell carcinoma.
abstract: The factors predisposing to adrenal metastasis in renal cell carcinoma were reviewed in 695 cases. The overall incidence of adrenal metastasis was 4.3%. The risk of adrenal metastasis correlated with tumors that were on the left side, large and replacing the entire kidney, upper pole in location and of advanced T stage. Nevertheless, microscopic and/or contralateral adrenal metastasis was noted in patients with smaller, lower pole or mid renal tumors. Of 30 patients with adrenal metastasis 9 (30%) had clinical evidence of widespread disease. Among the patients who underwent complete surgical resection 14% had either positive lymph nodes or other non-adrenal metastases. Of the patients undergoing resection 81% died, with a mean postoperative survival of 27 months. Sustained disease-free survival was noted in 3 patients (0.43% of the entire series) whose complete pathological staging was pT1-3b, N0, M0. The need and benefit of adrenalectomy during surgery for renal cell carcinoma are extremely limited.
authors.affiliation: Division of Urology, University of Texas Southwestern Medical Center, Dallas.
authors.forename: A I
authors.initials: AI
authors.lastname: Sagalowsky
authors.forename: K T
authors.initials: KT
authors.lastname: Kadesky
authors.forename: D M
authors.initials: DM
authors.lastname: Ewalt
authors.forename: T J
authors.initials: TJ
authors.lastname: Kennedy
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000556:secondary*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000401:mortality / Q000556:secondary* / Q000601:surgery; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate