title: Surgical resection of isolated adrenal metastases in patients with non-small cell lung cancer: a single-institution experience and review of the literature.
abstract: BACKGROUND
  In non-small cell lung cancer (NSCLC), the benefits of resection of solitary adrenal metastases for survival and the identification of patients most likely to benefit from adrenalectomy are unknown.
  
  
  METHODS
  We retrospectively reviewed clinico-pathological factors and outcomes in 4 NSCLC patients treated with adrenalectomy at our centre. We reviewed the published literature with a focus on long-term survivors in order to formulate treatment recommendations.
  
  
  RESULTS
  Local pathological staging showed stages IA-IIA. All had a performance status (PS) of 0. The median age was 56 years (range: 53-58 years). Adrenal metastases were detected by positron emission tomography-computed tomography (PET-CT) in 3 patients. Median time from lobectomy to occurrence of metachronous adrenal metastases was 12.3 months (11-14 months). The perioperative mortality was zero. All patients recurred systemically after adrenalectomy within 2-49 months. 3 patients died due to systemic progression 6-15 months after adrenalectomy. 1 patient is alive with pulmonary relapse 49 months after adrenalectomy.
  
  
  CONCLUSIONS
  Resection of solitary adrenal metastases in selected good-PS NSCLC patients with minimal local nodal involvement from the primary tumour is associated with low morbidity and may offer a chance for long-term disease-free survival in a small subset of patients. Careful pre-operative staging including PET-CT is warranted.
authors.affiliation: Department of Oncology/Hematology, Kantonsspital St. Gallen, Switzerland.
authors.forename: Sara
authors.initials: S
authors.lastname: Bastian
authors.forename: Thomas
authors.initials: T
authors.lastname: Clerici
authors.forename: Jörg
authors.initials: J
authors.lastname: Neuweiler
authors.forename: Thomas
authors.initials: T
authors.lastname: Cerny
authors.forename: Martin
authors.initials: M
authors.lastname: Früh
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D000315:Adrenalectomy / Q000401:mortality* / Q000706:statistics & numerical data; D002289:Carcinoma, Non-Small-Cell Lung / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000401:mortality* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D016019:Survival Analysis; D015996:Survival Rate; D013557:Switzerland / Q000453:epidemiology; D016896:Treatment Outcome