Porte H, Siat J, Guibert B, Lepimpec-Barthes F, Jancovici R, Bernard A, Foucart A, Wurtz A
Clinique Chirurgicale, H pital A. Calmette Centre Hospitalier et Universitaire de Lille, France.
Ann Thorac Surg. 2001 Mar;71(3):981-5. doi: 10.1016/s0003-4975(00)02509-1.
In recent case reports and limited series, adrenalectomy was recommended for an isolated adrenal metastasis from non-small cell lung cancer (NSCLC).
We retrospectively studied patients with a solitary adrenal metastasis from NSCLC who had undergone potentially curative resection in eight centers.
Forty-three patients were included. Their adrenal gland metastasis was discovered synchronously with NSCLC in 32 patients, and metachronously in 11. It was homolateral to the NSCLC in 31 patients and contralateral in 12 (p < 0.01). Median survival was 11 months, and 3 patients survived more than 5 years. There was no difference between the synchronous and metachronous groups regarding recurrence rate or survival. Survival was not affected by the homolateral location of the metastasis, the histology of the NSCLC, TNM stage, any adjuvant and neoadjuvant treatment, or, in the metachronous group, a disease-free interval exceeding 6 months.
We confirm the possibility of long-term survival after resection of isolated adrenal metastasis from NSCLC, but no clinical or pathologic criteria were detected to identify patients amenable to potential cure.
在最近的病例报告和有限系列研究中,对于非小细胞肺癌(NSCLC)孤立性肾上腺转移瘤,建议行肾上腺切除术。
我们回顾性研究了在八个中心接受了可能治愈性切除的NSCLC孤立性肾上腺转移患者。
共纳入43例患者。其中32例患者的肾上腺转移瘤与NSCLC同时发现,11例为异时发现。31例患者的肾上腺转移瘤与NSCLC同侧,12例为对侧(p<0.01)。中位生存期为11个月,3例患者存活超过5年。同时性和异时性组在复发率或生存率方面无差异。生存不受转移瘤同侧位置、NSCLC组织学类型、TNM分期、任何辅助和新辅助治疗的影响,在异时性组中,也不受无病间期超过6个月的影响。
我们证实了NSCLC孤立性肾上腺转移瘤切除术后长期生存的可能性,但未发现可识别适合潜在治愈患者的临床或病理标准。