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Marc De Perrot - One of the best experts on this subject based on the ideXlab platform.
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surgical treatment of solitary Adrenal Metastasis from non small cell lung cancer
The Journal of Thoracic and Cardiovascular Surgery, 2005Co-Authors: Olaf Mercier, Elie Fadel, Marc De Perrot, Sacha Mussot, Franco Stella, Alain Chapelier, Philippe DartevelleAbstract:Background Management of solitary Adrenal Metastasis from non-small cell lung cancer is still debated. Although classically considered incurable, various reports with small numbers of patients have shown that surgical treatment might improve long-term survival. The aim of this study was to review our experience and to identify factors that could affect survival. Methods From January 1989 through April 2003, 23 patients underwent complete resection of an isolated Adrenal Metastasis after surgical treatment of non-small cell lung cancer. There were 19 men and 4 women, with a mean age of 54 ± 10 years. The diagnosis of Adrenal Metastasis was synchronous with the diagnosis of non-small cell lung cancer in 6 patients and metachronous in 17 patients. The median disease-free interval for patients with metachronous Metastasis was 12.5 months (range, 4.5–60.1 months). Results The overall 5-year survival was 23.3%. Univariate and multivariate analysis demonstrated that a disease-free interval of greater than 6 months was an independent and significant predictor of increased survival in patients after Adrenalectomy. All patients with a disease-free interval of less than 6 months died within 2 years of the operation. The 5-year survival was 38% after resection of an isolated Adrenal Metastasis that occurred more than 6 months after lung resection. Adjuvant therapy and pathologic staging of non-small cell lung cancer did not affect survival. Conclusions Surgical resection of metachronous isolated Adrenal Metastasis with a disease-free interval of greater than 6 months can provide long-term survival in patients previously undergoing complete resection of the primary non-small cell lung cancer.
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long term survival after surgical resections of bronchogenic carcinoma and Adrenal Metastasis
The Annals of Thoracic Surgery, 1999Co-Authors: Marc De Perrot, Marc Licker, John Robert, Anastase SpiliopoulosAbstract:There is some evidence that complete resection of both primary and metastatic sites of non-small cell lung carcinoma has more influence on survival than the locoregional stage of the lung cancer. We describe prolonged survival (> 5 years) after complete surgical resection of a bronchogenic carcinoma (T3N0M1) and solitary Adrenal Metastasis.
Rainer Hofmann - One of the best experts on this subject based on the ideXlab platform.
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Simultaneous Adrenalectomy During Radical Nephrectomy for Renal Cell Carcinoma Will Not Cure Patients With Adrenal Metastasis
Urology, 2008Co-Authors: R Von Knobloch, A. J. Schrader, E. M. Walthers, Rainer HofmannAbstract:Objectives To present data from all patients with Adrenal involvement after prolonged follow-up and to revise our advice given in 1999. In 1999, we published our results for a large series of patients with Adrenal Metastasis from renal cell carcinoma. Methods The charts of 617 patients who had undergone radical nephrectomy with simultaneous Adrenalectomy for renal cell carcinoma at the Department of Urology, Philipps-University Medical School, Marburg from 1985 to 1999 were retrospectively reviewed. In 1999, 23 of 617 patients (3.7%) were found to have Adrenal Metastasis. The 23 patients included 16 with unilateral ipsilateral Adrenal Metastasis only, 1 with unilateral contralateral Metastasis, and 6 with bilateral Adrenal involvement. The postoperative course of the 23 patients has been updated regarding progression and survival after surgery. Results After a mean follow-up of 59.1 months (range 1.1-156.7), only 5 patients were still alive, all with progressive disease. With a mean interval to death of 41.7 months (range 1.1-126.0), 18 patients had died, 17 of whom had cancer progression. One patient died without signs of disease recurrence 49.1 months after radical nephrectomy and simultaneous ipsilateral Adrenalectomy. The mean time to progression was 34.2 months (range 0-91.5). Conclusions With these data available, we are now aware that we cannot cure patients with Adrenal Metastasis by incorporating simultaneous ipsilateral Adrenalectomy into routine radical nephrectomy for renal cell carcinoma. The routine incorporation of ipsilateral Adrenalectomy should, therefore, be abandoned.
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contralateral Adrenal Metastasis of renal cell carcinoma treatment outcome and a review
BJUI, 2003Co-Authors: R Von Knobloch, Rainer HofmannAbstract:The group from the Mayo Clinic review their experience with contralateral Adrenal Metastasis in 11 patients, two with synchronous and nine with metachronous metastases, all being treated by Adrenalectomy. Although nine of the 11 patients had died from RCC by the time of review, the authors felt that removal of contralateral Adrenal Metastasis had a beneficial effect; this sustains the belief that surgical removal of solitary metastases is advisable. Urologists from London address the concept of surgical variables as being of major importance. We will be hearing more about ‘under performing surgeons’, and I felt that an editorial comment from two European urologists would help to put the article in place for the reader. I can guarantee that further views are on their way about this important topic. Screening for prostate cancer has occupied many column inches in most urological Journals, and readers are of course aware of the randomized studies being conducted in North America, Europe and elsewhere. Authors from South Africa describe some of the problems associated with developing a screening programme in a less developed part of the world. They show that it can be extremely difficult to induce patients screened for the PSA to attend for their prostate biopsy. OBJECTIVE To report the surgical treatment of patients with renal cell carcinoma (RCC) metastatic to the contralateral Adrenal gland and compare our experience with previous reports, as such metastases are found in 2.5% of patients with metastatic RCC at autopsy, and the role of resecting metastatic RCC at this site is not well defined. PATIENTS AND METHODS We retrospectively identified 11 patients who had surgery for metastatic RCC to the contralateral Adrenal gland between October 1978 and April 2001. The patients’ medical records were reviewed for clinical, surgical and pathological features, and the patients’ outcome. RESULTS The mean (median, range) age of the patients at primary nephrectomy was 60.9 (64, 43–79) years; all had clear cell (conventional) RCC. Synchronous contralateral Adrenal Metastasis occurred in two patients. The mean (median, range) time to contralateral Adrenal Metastasis after primary nephrectomy for the remaining nine patients was 5.2 (6.1, 0.8–9.2) years. All patients were treated with Adrenalectomy; there were no perioperative complications or mortality. Seven patients died from RCC at a mean (median, range) of 3.9 (3.7, 0.2–10) years after Adrenalectomy for contralateral Adrenal Metastasis; one died from other causes at 3.4 years, one from an unknown cause at 1.7 years and two were still alive at the last follow-up. CONCLUSIONS The surgical resection of contralateral Adrenal Metastasis from RCC is safe; although most patients died from RCC, survival may be prolonged in individual patients. Hence, in the era of cytoreductive surgery, the removal of solitary contralateral Adrenal Metastasis seems to be indicated.
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Management of contralateral Adrenal Metastasis from renal cell carcinoma: possibility of inferior vena cava tumour thrombus.
Scandinavian journal of urology and nephrology, 2000Co-Authors: Von Knobloch R, Hegele A, Kälble T, Rainer HofmannAbstract:Objective: The contralateral Adrenal gland is a rare metastatic site in renal cell carcinoma (RCC). We describe our experiences with this Metastasis in a cohort of 610 radical nephrectomy patients analysed. To our knowledge this study is the first to demonstrate an inferior vena cava tumour thrombus from metachronous contralateral Adrenal Metastasis. Patients and methods: After radical nephrectomy for RCC, 610 patients treated at our institution from 1985-99 were retrospectively investigated for the incidence of contralateral Adrenal Metastasis, additional clinical findings, treatment modalities and survival after treatment for contralateral Adrenal gland Metastasis. Results: The incidence of contralateral Adrenal Metastasis was 1.1% (7/610 patients), while the incidence of ipsilateral Metastasis was 3.4% (21/610). In 3 of 7 cases the contralateral Adrenal Metastasis occurred simultaneously with primary RCC in the kidney. The contralateral Adrenal gland was affected by distant tumour spread metachronously...
Philippe Dartevelle - One of the best experts on this subject based on the ideXlab platform.
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Is surgery required for patients with isolated Adrenal Metastasis of non-small cell lung carcinoma?
Presse medicale (Paris France : 1983), 2007Co-Authors: Olaf Mercier, Elie Fadel, Sacha Mussot, Alain Chapelier, Dominique Fabre, Olivier Chataigner, Philippe DartevelleAbstract:No consensus yet governs management of solitary Adrenal Metastasis of non-small cell lung cancer (NSCLC). Although classically considered incurable, various case reports and small series indicate that surgical treatment may improve long-term survival. The aim of this study was to review our experience and to identify factors that may affect survival. From January 1989 through June 2006, 26 patients (21 men and 5 women; mean age: 54+/-10 years) underwent complete resection of an isolated Adrenal Metastasis after surgical treatment of NSCLC. The Adrenal Metastasis was diagnosed at the same time as the NSCLC in 6 patients and subsequently in 20 patients. Median disease-free interval for patients with metachronous Metastasis was 13.8 months (range: 4.5 to 60.1 months). The overall 5- and 10-year survival rates were 31 and 21% respectively. Univariate and multivariate analysis showed that a disease-free interval longer than 6 months was a significant independent predictor of longer survival in patients after Adrenalectomy. All patients with a disease-free interval of less than 6 months died within 2 years of surgery. After resection of an isolated Adrenal Metastasis diagnosed more than 6 months after lung resection, the 5-year survival rate was 49%. Adjuvant therapy and pathological staging of NSCLC did not affect survival. Surgical resection of subsequent isolated Adrenal Metastasis with a disease-free interval longer than 6 months can lead to long-term survival in patients with previous complete resection of the primary NSCLC.
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surgical treatment of solitary Adrenal Metastasis from non small cell lung cancer
The Journal of Thoracic and Cardiovascular Surgery, 2005Co-Authors: Olaf Mercier, Elie Fadel, Marc De Perrot, Sacha Mussot, Franco Stella, Alain Chapelier, Philippe DartevelleAbstract:Background Management of solitary Adrenal Metastasis from non-small cell lung cancer is still debated. Although classically considered incurable, various reports with small numbers of patients have shown that surgical treatment might improve long-term survival. The aim of this study was to review our experience and to identify factors that could affect survival. Methods From January 1989 through April 2003, 23 patients underwent complete resection of an isolated Adrenal Metastasis after surgical treatment of non-small cell lung cancer. There were 19 men and 4 women, with a mean age of 54 ± 10 years. The diagnosis of Adrenal Metastasis was synchronous with the diagnosis of non-small cell lung cancer in 6 patients and metachronous in 17 patients. The median disease-free interval for patients with metachronous Metastasis was 12.5 months (range, 4.5–60.1 months). Results The overall 5-year survival was 23.3%. Univariate and multivariate analysis demonstrated that a disease-free interval of greater than 6 months was an independent and significant predictor of increased survival in patients after Adrenalectomy. All patients with a disease-free interval of less than 6 months died within 2 years of the operation. The 5-year survival was 38% after resection of an isolated Adrenal Metastasis that occurred more than 6 months after lung resection. Adjuvant therapy and pathologic staging of non-small cell lung cancer did not affect survival. Conclusions Surgical resection of metachronous isolated Adrenal Metastasis with a disease-free interval of greater than 6 months can provide long-term survival in patients previously undergoing complete resection of the primary non-small cell lung cancer.
Michael L. Blute - One of the best experts on this subject based on the ideXlab platform.
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Contralateral Adrenal Metastasis of renal cell carcinoma: treatment, outcome and a review: CONTRALATERAL Adrenal Metastasis FROM RCC
BJU international, 2003Co-Authors: W.k. Lau, Horst Zincke, Christine Lohse, John C. Cheville, A.l. Weaver, Michael L. BluteAbstract:To report the surgical treatment of patients with renal cell carcinoma (RCC) metastatic to the contralateral Adrenal gland and compare our experience with previous reports, as such metastases are found in 2.5% of patients with metastatic RCC at autopsy, and the role of resecting metastatic RCC at this site is not well defined. We retrospectively identified 11 patients who had surgery for metastatic RCC to the contralateral Adrenal gland between October 1978 and April 2001. The patients' medical records were reviewed for clinical, surgical and pathological features, and the patients' outcome. The mean (median, range) age of the patients at primary nephrectomy was 60.9 (64, 43-79) years; all had clear cell (conventional) RCC. Synchronous contralateral Adrenal Metastasis occurred in two patients. The mean (median, range) time to contralateral Adrenal Metastasis after primary nephrectomy for the remaining nine patients was 5.2 (6.1, 0.8-9.2) years. All patients were treated with Adrenalectomy; there were no perioperative complications or mortality. Seven patients died from RCC at a mean (median, range) of 3.9 (3.7, 0.2-10) years after Adrenalectomy for contralateral Adrenal Metastasis; one died from other causes at 3.4 years, one from an unknown cause at 1.7 years and two were still alive at the last follow-up. The surgical resection of contralateral Adrenal Metastasis from RCC is safe; although most patients died from RCC, survival may be prolonged in individual patients. Hence, in the era of cytoreductive surgery, the removal of solitary contralateral Adrenal Metastasis seems to be indicated.
Soo Bang Ryu - One of the best experts on this subject based on the ideXlab platform.
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Metachronous Solitary Contralateral Adrenal Metastasis of Renal Cell Carcinoma
Chonnam Medical Journal, 2009Co-Authors: Eu Chang Hwang, Seung Il Jung, Jun Back Park, Sun-ouck Kim, Taek Won Kang, Dong Deuk Kwon, Kwangsung Park, Soo Bang RyuAbstract:Renal cell carcinomas can metastasize to almost any organ. Metachronous solitary contralateral Adrenal Metastasis from renal cell carcinoma is, however, very rare. Surgical resection is appropriate in isolated metastatic renal cell carcinoma, but the metastasectomy in the case of contralateral Adrenal Metastasis of renal cell carcinoma has not been well defined. Herein, we report a case of renal cell carcinoma with solitary metachronous contralateral Adrenal Metastasis occurring 4 years after curative laparoscopic radical nephrectomy. The patient was treated with retroperitoneal laparoscopic Adrenalectomy.
