title: Adrenal metastasis from hepatocellular carcinoma: radiofrequency ablation combined with adrenal arterial chemoembolization in six patients.
abstract: OBJECTIVE
  The purpose of this study was to evaluate the clinical utility of adrenal radiofrequency ablation combined with adrenal arterial chemoembolization in the treatment of patients with adrenal metastasis of hepatocellular carcinoma.
  
  
  METHODS
  This retrospective study was conducted at two institutions. Adrenal radiofrequency ablation and chemoembolization were performed on the same day. Safety, local tumor progression, and survival were evaluated.
  
  
  RESULTS
  Six patients with eight adrenal metastatic lesions were treated. The mean maximum diameter of the lesions was 5.2 +/- 1.8 cm (range, 3.5-8.0 cm). During initial combination therapy, an adrenal metastatic lesion was isolated in one patient. The other five patients had four associated intrahepatic lesions and three extraadrenal distant metastatic lesions. On contrast-enhanced CT scans, tumor enhancement of all eight adrenal tumors ceased after combination therapy. No major complications were related to combination therapy. During the mean follow-up period of 37.7 +/- 27.6 months (range, 4.0-70.9 months), two of eight adrenal tumors (25%) had undergone local tumor progression. The median survival time was 24.9 months. Three patients treated for both intrahepatic and extrahepatic lesions survived longer than 4 years.
  
  
  CONCLUSIONS
  The combination therapy described is a safe multidisciplinary therapeutic option that can lengthen survival among patients with adrenal metastasis from hepatocellular carcinoma.
authors.affiliation: Department of Radiology, Mie University School of Medicine, Japan. yama@clin.medic.mie-u.ac.jp
authors.forename: Koichiro
authors.initials: K
authors.lastname: Yamakado
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Anai
authors.forename: Haruyuki
authors.initials: H
authors.lastname: Takaki
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Sakaguchi
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Tanaka
authors.forename: Kimihiko
authors.initials: K
authors.lastname: Kichikawa
authors.forename: Kan
authors.initials: K
authors.lastname: Takeda
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary* / Q000628:therapy*; D000311:Adrenal Glands / Q000098:blood supply / Q000000981:diagnostic imaging / Q000187:drug effects; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000556:secondary* / Q000628:therapy*; D017115:Catheter Ablation; D003131:Combined Modality Therapy; D004621:Embolization, Therapeutic; D005260:Female; D006490:Hemostatics / Q000008:administration & dosage*; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D006490:Hemostatics