[Adrenalectomy within the scope of tumor nephrectomy--overtreatment?].
Metastatic spread to the ipsilateral adrenal gland occurs in 1.2-10% of patients with renal cell carcinoma (RCC). In the majority of these cases, the primary tumor is locally advanced with poor differentiation, venous invasion, and involvement of the regional lymph nodes. Adrenal metastases are usually detected preoperatively by CT scan or MRI. Adrenal metastases are indicators of systemic disease with poor prognosis quo ad vitam. Only 0.5-2.3% of patients with RCC and adrenal metastases are free of venous invasion or lymphatic disease. In this small subset of patients, cure is possible by surgical removal of the adrenal gland. In 97.7-99.5% of patients with RCC, ipsilateral adrenalectomy has no impact on their prognosis. We therefore conclude that this procedure should be performed only if there is radiological suspicion of an adrenal mass.
Kiesow
U
U
Urologische Klinik, Julius-Maximilians-Universität Würzburg. Josef-Schneider-Strasse 2, 97080 Würzburg.
Kieser
W
W
Köhl
U
U
Weingärtner
K
K
Riedmiller
H
H
D000311:Adrenal Glands / Q000473:pathology; D000315:Adrenalectomy; D002292:Carcinoma, Renal Cell / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007668:Kidney / Q000473:pathology; D007680:Kidney Neoplasms / Q000473:pathology / Q000601:surgery*; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D009360:Neoplastic Cells, Circulating; D009392:Nephrectomy; D019564:Unnecessary Procedures