[Surgical treatment of adrenal gland metastases: results in a series of 35 patients].
BACKGROUND
The objectives of this study are to present the results of adrenalectomies due to metastasis, and to analyse the prognostic factors that may help to predict long-term survival in this patient group.


METHODS
A retrospective study was conducted on 35 patients who underwent adrenalectomy for metastases in the Hospital de Cruces from 1996 to January 2010. The survival analysis was performed using the Kaplan and Meier method.


RESULTS
Non-small cell lung cancer (NSCLC) was the most frequent primary tumour, with 18 cases. In 15 patients the diagnosis of adrenal metastasis was synchronous with the primary tumour, and in 20 cases it was metachronous. Only 7 patients survived without disease for 12, 22, 26, 58, 60, 65 and 120 months after the adrenalectomy. The disease free survival at 5 years was 16% in the whole series, and 27% in the NSCLC sub-group. None of the prognostic factors evaluated (size greater than 4.5 cm, cell type, differentiation grade, chemotherapy, surgical technique, disease free interval) was statistically significant in the overall survival, either in the general series or in the sub-group of patients with NSCLC. However, in the general series with tumour recurrence, the difference in survival between metachronous and synchronous metastasis was statistically significant (P=.05), in favour of the former.


CONCLUSIONS
Adrenalectomy improves the expected survival particularly in patients with NSCLC. Patients with metachronous metastases do not have a higher rate of disease free survival at 5 years than those with synchronous metastases, although they do have a longer survival with the disease. When there is tumour recurrence, it is usually early.
Unidad de Cirugía Endocrina, Servicio de Cirugía General, Hospital de Cruces, Baracaldo, Vizcaya, España. Aitor.quintanadelabasarrate@osakidetza.net
Aitor
A
de la Quintana Basarrate
Gloria
G
Martínez Fernández
Ainhoa
A
Arana González
Mikel
M
Prieto
Irene
I
Alvarez
Lorea
L
Martínez Indart
José María
JM
García González
Luis Fernando
LF
Perdigo Bilbao
Alberto
A
Colina Alonso
D000310:Adrenal Gland Neoplasms / Q000556:secondary* / Q000601:surgery*; D000315:Adrenalectomy; D000328:Adult; D000368:Aged; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies