Elsevier

The Annals of Thoracic Surgery

Volume 62, Issue 6, December 1996, Pages 1614-1616
The Annals of Thoracic Surgery

Does Resection of Adrenal Metastases From Non-Small Cell Lung Cancer Improve Survival?

https://doi.org/10.1016/S0003-4975(96)00611-XGet rights and content

Abstract

Background. Metastatic non-small cell lung cancer (NSCLC) carries a dismal prognosis, which is minimally affected by chemotherapy. Solitary brain metastases from NSCLC have been resected with 5-year survivals of 10% to 30%. The objective of this study was to determine if resection of isolated adrenal metastases improves survival.

Methods. Isolated adrenal metastases were found in 14 patients with NSCLC. Eight patients had resection after cis-platinum-based chemotherapy, and 6 received chemotherapy alone.

Results. Median survival in the surgical group was significantly greater than that in the chemotherapy group (31 versus 8.5 months; p = 0.03). All patients in the chemotherapy group were dead by 22 months. Three-year actuarial survival in the surgical group was 38%. No difference in locoregional stage, size of adrenal metastases, patient age, or performance status was present between the two groups.

Conclusions. Long-term disease-free survival is possible after resection of isolated adrenal metastases from NSCLC. Resection of isolated adrenal metastases should be considered if the primary NSCLC is resectable.

Section snippets

Material and Methods

We performed a retrospective review of patients with the diagnosis of NSCLC and a solitary adrenal metastasis who presented to Memorial Sloan Kettering Cancer Center from 1987 to 1993. Eligibility criteria included a resectable primary NSCLC, a solitary adrenal metastasis, good performance status (Eastern Cooperative Oncology Group class 0 or 1), no history of other malignancies, and an otherwise negative metastatic survey. Patients were selected for chemotherapy alone or chemotherapy followed

Results

Fourteen patients treated for an isolated adrenal metastasis were identified. All adrenal metastases in the current series were detected during the workup of the primary lung cancer. The adrenal metastases were verified by histologic review of percutaneous needle biopsy or open biopsy specimens. There was no difference in age, sex, performance status, tumor histology, or size of adrenal metastasis between the two groups (Table 1). There was no significant difference in the locoregional stage of

Comment

More than 170,000 new cases of lung cancer are diagnosed each year; 80% are non-small cell and 20% are small cell lung cancer. Of the NSCLC, 50% are considered unresectable at the time of diagnosis due to the presence of distant metastases. In a review of more than 2,500 patients presenting with metastatic NSCLC, Albain and associates [1]reported 7% had a solitary site of metastasis. In this group, a multivariate analysis revealed that a solitary site of metastasis was a favorable prognostic

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