Itou S, Imai T, Usami N, Uchiyama M, Yasuda A, Kawaguchi K, Yokoi K
Division of General Thoracic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Kyobu Geka. 2006 Jan;59(1):47-52.
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. We have experienced 6 cases of patients who had adrenalectomy (ADR) for a metastasis from NSCLC. The median survival time (MST) after ADR was 24 months, and there was only 1 case of 3-year survivor. To elucidate the surgical indication and the prognostic factors of patients with a solitary adrenal metastasis from NSCLC, we analyzed 104 patients including our 6 patients who had ADR for a metastasis from NSCLC. The MST after ADR and 5-year survival were 24 months and 31%, respectively. Univariate and multivariate analysis demonstrated that lymph node metastasis at the surgery for primary lung cancer was the only significant and independent predictor of poor survival in patients after ADR. The results suggest that aggressive surgical treatment of a solitary adrenal metastasis from NSCLC may be effective when a patient have N0 disease.
在病例报告和少量患者的病例系列中，已有数例非小细胞肺癌（NSCLC）孤立性肾上腺转移灶手术切除后的长期存活者被报道。我们诊治过6例因NSCLC转移而行肾上腺切除术（ADR）的患者。ADR后的中位生存时间（MST）为24个月，仅有1例存活3年。为阐明NSCLC孤立性肾上腺转移患者的手术指征和预后因素，我们分析了104例患者，包括我们诊治的6例因NSCLC转移而行ADR的患者。ADR后的MST和5年生存率分别为24个月和31%。单因素和多因素分析表明，原发性肺癌手术时的淋巴结转移是ADR后患者生存不良的唯一显著且独立的预测因素。结果提示，当患者为N0期疾病时，对NSCLC孤立性肾上腺转移进行积极的手术治疗可能有效。
