PURPOSE: Several long-term survivors after surgical resection for a solitary adrenal metastasis from non-small cell lung cancer (NSCLC) have been reported in case reports and case series with a small number of patients. The aim of this study was to elucidate the surgical indication and prognostic factors.
METHODS: From January 1999 through December 2004, 6 patients underwent From January 1999 through December 2004, 6 patients underwent resection of an adrenal recurrence after surgical treatment of NSCLC in our institution. We searched the PubMed database for articles published from 1972 to 2005 and identified 98 reported cases of adrenalectomy (ADR) for metastasis or recurrence of lung cancer in 29 articles in which the outcomes were distinctly described. These 104 cases constituted the study population and were analyzed the relationship between the survivals and various potential prognostic factors individually. The factors included histological type, tumor size, lymph node metastasis (N) of primary lung cancer, time phase of adrenal metastasis, disease-free interval, laterality (ipsilateral or contralateral), and performance of adjuvant therapy for adrenal metastasis.
RESULTS: The median survival time (MST) after ADR and five-years survival were 24 months and 31%, respectively. There were 11 five-year survivors, and all patients but one had N0 disease. Univariate and multivariate analysis demonstrated that lymph node metastasis at the surgery for primary lung cancer was an only significant and independent predictor of poor survival in patients after ADR.
CONCLUSION: The results suggest that aggressive surgical treatment of a solitary adrenal metastasis from NSCLC may be effective when a patient have N0 disease.
CLINICAL IMPLICATIONS: Surgery for a solitary adrenal metastasis from NSCLC could be a curative treatment in patients with pN0 disease.
DISCLOSURE: Simon Itoh, None.