A comparison of adrenalectomy with other resections for metastatic cancers.
BACKGROUND
Although adrenal metastases were once considered incurable, recent anecdotal reports recommend adrenalectomy for isolated metastases.


METHODS
Computerized files of all US Department of Veterans Affairs (DVA) hospital admissions and deaths from 1988 to 1994 identified patients undergoing isolated adrenal resections, and hospitalization records were obtained. Patients without a death record were assumed to be alive.


RESULTS
In 47 patients with adrenalectomy for metastases, only 5 patients did not die within 3 years: 2 each had metachronous renal or colorectal metastases, and 1 had a pulmonary primary. Thirteen patients with other primary sites all expired within 3 years. Operative mortality was 4% in these 47 patients and also in 706 other adrenalectomies without metastases.


CONCLUSIONS
Adrenalectomy for metastatic carcinoma in the DVA was safe, with a projected 5-year survival rate (13%) that is significantly inferior (P < or = 0.05) to resections for colorectal metastases to lung (36%) or liver (26%), but superior to brain (none).
Wade
T P
TP
Department of Surgery, John Cochran VA Medical Center and St. Louis University School of Medicine, Missouri, USA.
Longo
W E
WE
Virgo
K S
KS
Johnson
F E
FE
D000310:Adrenal Gland Neoplasms / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D000315:Adrenalectomy; D000704:Analysis of Variance; D001932:Brain Neoplasms / Q000401:mortality / Q000556:secondary; D015179:Colorectal Neoplasms / Q000473:pathology; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary; D008175:Lung Neoplasms / Q000401:mortality / Q000556:secondary; D008875:Middle Aged; D016019:Survival Analysis; D014481:United States / Q000453:epidemiology; D014728:Veterans