title: What is the best treatment modality for adrenal metastasis from hepatocellular carcinoma?
abstract: OBJECTIVE
  This study aimed to analyze the effect of each therapeutic modality to clarify the treatment strategy for adrenal metastases from hepatocellular carcinoma (HCC).
  
  
  METHODS
  Adrenal metastasis from HCC was observed in 45 patients. Fifteen patients who were determined to have multi-organ metastasis including the adrenal glands were excluded, and the remaining 30 patients were reviewed.
  
  
  RESULTS
  The location of adrenal metastasis was right side, left side, and both in 17, 9, and 4 patients, respectively. Treatment for adrenal metastasis consisted of adrenalectomy in 5 patients, non-surgical treatment such as TACE, or chemotherapy and radiotherapy in 19 patients, while 6 patients received no treatment. The median survival duration was 11.05 months in the 30 patients with adrenal metastasis. In the 25 patients with well-controlled intrahepatic lesions, the median survival time of those patients who received adrenalectomy, non-surgical treatment, and no treatment was 21.41, 11.05, and 5.64 months, respectively. The difference in cumulative survival according to mode of treatment of adrenal metastasis in the well-controlled intrahepatic lesion group was statistically significant.
  
  
  CONCLUSIONS
  We envisage increased benefit after adrenalectomy in terms of survival in patients with well controlled intrahepatic lesions at the time of adrenal metastasis and good general medical condition.
authors.affiliation: Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Joon Seong
authors.initials: JS
authors.lastname: Park
authors.forename: Dong Sup
authors.initials: DS
authors.lastname: Yoon
authors.forename: Kyung Sik
authors.initials: KS
authors.lastname: Kim
authors.forename: Jin Sub
authors.initials: JS
authors.lastname: Choi
authors.forename: Woo Jung
authors.initials: WJ
authors.lastname: Lee
authors.forename: Hoon Sang
authors.initials: HS
authors.lastname: Chi
authors.forename: Byong Ro
authors.initials: BR
authors.lastname: Kim
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000401:mortality / Q000556:secondary* / Q000628:therapy*; D000315:Adrenalectomy; D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000556:secondary*; D016461:Chemoembolization, Therapeutic; D003131:Combined Modality Therapy; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate