[Ipsilateral adrenalectomy is not obligatory in nephrectomy for renal cell carcinoma].
To analyse the necessity of obligatory ipsilateral adrenalectomy (IA) for renal cell carcinoma (RCC), we made a study of 329 RCC patients operated from 2002 to 2007. Nephrectomy was conducted in 208 (63.2%) patients, renal resection--in 121 (36.8%), adrenalectomy--in 19 (5.8%) patients. High-contrast multislice computed tomography (HCMCT) was performed in all the patients. Preoperative HCMCT detected adrenal lesions in 62 (18.84%) patients. Adrenal adenoma was suspected in 39 (11.8%) patients: ipsilateral in 19 (48.77%), contralateral in 11 (28.23%), bilateral in 9 (23%) patients. Adrenal hyperplasy was diagnosed in 11 (3.34%) patients. It was ipsilateral in 5 (45.4%), contralateral in 4 (36.4%), bilateral in 2 (18.2%) patients. The tumor invaded the ipsilateral adrenal in 4 (1.2%) patients. A RCC metastasis into the adrenal was suspected in 8 (2.4%) patients. A synchroneous affection was seen in 5 (1.5%) patients: ipsilateral in 4 (80%) and bilateral in 1 (20%) patients. RCC invaded the ipsilateral adrenal in 1.2% patients with RCC, its adrenal metastasis was detected in 1.5% RCC patients. In preservation of the adrenal in adenoma or hyperplasy 5-year follow-up registered no changes. Neither pathological processes were diagnosed for 5 years in preservation of unaffected adrenal. Thus, adrenalectomy is not obligatory in radical nephrectomy.
Aliaev
Iu G
IuG
Akhvlediani
N D
ND
Blokhin
P S
PS
D000236:Adenoma / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D000310:Adrenal Gland Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000556:secondary / Q000601:surgery; D000315:Adrenalectomy; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed