METHODS: A multicenter retrospective study included patients who underwent adrenalectomy for adrenal metastasis in two Spanish hospitals between 2005 and 2021. Clinical variables associated with surgical complications and survival during follow-up were analyzed.
RESULTS: Thirty-three patients were included. Adrenalectomy was performed laparoscopically in 27 patients and by an open approach in 6. The most common primary tumor site was the lung (n=15), followed by the kidney (n=7). Most patients had metachronous lesions (n=28). Six patients (18.2%) had intra- and/or postoperative complications; synchronous metastasis was a risk factor (odds ratio 12.5 [1.45-107.6]) for their development. Progression-free survival and disease-specific survival were 7.5months (range 1-64) and 22.5months (6-120), respectively. Survival rates at 1, 2, 3 and 5years were 94%, 65%, 48% and 29%, respectively. Survival was significantly lower in patients with lung cancer than with other cancers (hazard ratio 4.23 [1.42-12.59]).
CONCLUSIONS: Adrenalectomy for solitary adrenal metastases was associated with intra- or postoperative complications in 18% of cases. Synchronous metastasis was a risk factor for complications.
方法:一项多中心回顾性研究包括2005年至2021年在西班牙两家医院因肾上腺转移而接受肾上腺切除术的患者。分析随访期间与手术并发症和生存率相关的临床变量。
结果:纳入33例患者。对27例患者进行了腹腔镜手术,对6例患者进行了开放手术。最常见的原发肿瘤部位是肺(n=15),其次是肾脏(n=7)。大多数患者有异时病变(n=28)。6例患者(18.2%)有手术中和/或术后并发症;同步转移是一个危险因素(比值比(OR)12.5[1.45-107.6])。无进展生存期和疾病特异性生存期分别为7.5个月(范围1-64)和22.5个月(6-120),分别。1、2、3、5年生存率为94%,65%,48%和29%,分别。肺癌患者的生存率明显低于其他癌症患者(风险比4.23[1.42-12.59])。
结论:在18%的病例中,孤立性肾上腺转移瘤的肾上腺切除术与术中或术后并发症相关。同步转移是并发症的危险因素。