title: Management of suspected adrenal metastases at 2 academic medical centers.
abstract: BACKGROUND
  The optimal management of suspected adrenal metastases remains controversial.
  
  
  METHODS
  This is a retrospective bi-institutional review of 37 patients who underwent adrenalectomy for suspected adrenal metastasis between 2001 and 2014.
  
  
  RESULTS
  Three (8%) patients had benign adenomas on final pathology. At a median follow-up of 21 months, 7 (32%) patients were alive with no evidence of disease and 7 (32%) were alive with recurrent disease. Recurrence-free survival (RFS) was 8 months; decreased RFS was associated with positive margins and size ≥6 cm. Overall survival (OS) was 29 months; decreased OS was associated with capsular disruption. There were no differences in RFS or OS by surgical approach.
  
  
  CONCLUSIONS
  The favorable OS supports adrenalectomy in select patients with suspected adrenal metastases. Minimally invasive adrenalectomy is safe and effective, but the surgical approach should be based on the ability to achieve a margin-negative resection with avoidance of capsular disruption.
authors.affiliation: Division of Surgical Oncology, Department of Surgery, Medical College of Wisconsin, 9200 W. Wisconsin Avenue, Milwaukee, WI 53226, USA.
authors.forename: Jason A
authors.initials: JA
authors.lastname: Glenn
authors.affiliation: Division of Surgical Oncology and Endocrine Surgery, Department of Surgery, Vanderbilt University Medical Center, Nashville, TN 37232, USA.
authors.forename: Colleen M
authors.initials: CM
authors.lastname: Kiernan
authors.affiliation: Division of Surgical Oncology, Department of Surgery, Medical College of Wisconsin, 9200 W. Wisconsin Avenue, Milwaukee, WI 53226, USA.
authors.forename: Tina W F
authors.initials: TW
authors.lastname: Yen
authors.affiliation: Division of Surgical Oncology and Endocrine Surgery, Department of Surgery, Vanderbilt University Medical Center, Nashville, TN 37232, USA.
authors.forename: Carmen C
authors.initials: CC
authors.lastname: Solorzano
authors.affiliation: Division of Surgical Oncology, Department of Surgery, Medical College of Wisconsin, 9200 W. Wisconsin Avenue, Milwaukee, WI 53226, USA.
authors.forename: Azadeh A
authors.initials: AA
authors.lastname: Carr
authors.affiliation: Division of Surgical Oncology, Department of Surgery, Medical College of Wisconsin, 9200 W. Wisconsin Avenue, Milwaukee, WI 53226, USA.
authors.forename: Douglas B
authors.initials: DB
authors.lastname: Evans
authors.affiliation: Division of Surgical Oncology, Department of Surgery, Medical College of Wisconsin, 9200 W. Wisconsin Avenue, Milwaukee, WI 53226, USA. Electronic address: tswang@mcw.edu.
authors.forename: Tracy S
authors.initials: TS
authors.lastname: Wang
mesh_terms: D000046:Academic Medical Centers; D000310:Adrenal Gland Neoplasms / Q000556:secondary* / Q000601:surgery*; D000315:Adrenalectomy; D000368:Aged; D003952:Diagnostic Imaging; D005260:Female; D006801:Humans; D061705:Image-Guided Biopsy; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
keywords: Adrenal biopsy; Adrenal metastasis; Adrenalectomy; Retroperitoneoscopic