title: Prognostic parameters after surgery for adrenal metastases: a single institution experience.
abstract: BACKGROUND
  Clinically isolated adrenal metastases are rare and therefore present a therapeutic challenge. We report our experience with surgery of adrenal metastases and analyze factors that may influence postoperative survival.
  
  
  METHODS
  A consecutive series of 31 patients (16 male, 15 female) underwent adrenal surgery for metastases at a single institution over 10-year period (1999-2008). The Kaplan-Meier method and log-rank test were used to determine overall survival. Potential prognostic factors were identified by univariate and multivariate Cox regression analysis.
  
  
  RESULTS
  The primary tumor diagnoses were non-small-cell lung carcinoma (NSCLC) 20, colorectal carcinoma 5, renal cell carcinoma (RCC) 2, malignant melanoma and breast carcinoma, one each. The median survival was 12 months, with one year and five year survival of 21% and 3.4% respectively. According to multivariate analysis independent prognostic factors of favorable survival were disease free interval (DFI) longer than 12 months (Hazard ratio (HR) = 0.28, 95% CI = 0.09-0.90), potentially curative resection (Hazard ratio (HR) = 0.35, 95% CI = 0.12-1.00) and postoperative radiotherapy of adrenal bed (Hazard ratio (HR) = 0.33, 95% CI = 0.12-0.91).
  
  
  CONCLUSIONS
  Overall survival after surgery for adrenal metastases is poor. In multivariate analyses, survival is influenced by DFI, curative resection, and postoperative radiotherapy.
authors.forename: I
authors.initials: I
authors.lastname: Paunovic
authors.forename: V
authors.initials: V
authors.lastname: Zivaljevic
authors.forename: A
authors.initials: A
authors.lastname: Diklic
authors.forename: K
authors.initials: K
authors.lastname: Tausanovic
authors.forename: R
authors.initials: R
authors.lastname: Stojanic
authors.forename: S
authors.initials: S
authors.lastname: Sipetic
mesh_terms: D000310:Adrenal Gland Neoplasms / Q000401:mortality / Q000556:secondary / Q000628:therapy; D000315:Adrenalectomy; D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000473:pathology; D002277:Carcinoma / Q000401:mortality / Q000473:pathology / Q000556:secondary / Q000628:therapy; D015179:Colorectal Neoplasms / Q000473:pathology; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology; D008175:Lung Neoplasms / Q000473:pathology; D008297:Male; D008545:Melanoma / Q000401:mortality / Q000473:pathology / Q000556:secondary / Q000628:therapy; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D012878:Skin Neoplasms / Q000473:pathology