Park Joon Seong, Yoon Dong Sup, Kim Kyung Sik, Choi Jin Sub, Lee Woo Jung, Chi Hoon Sang, Kim Byong Ro
Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.
J Surg Oncol. 2007 Jul 1;96(1):32-6. doi: 10.1002/jso.20773.
This study aimed to analyze the effect of each therapeutic modality to clarify the treatment strategy for adrenal metastases from hepatocellular carcinoma (HCC).
Adrenal metastasis from HCC was observed in 45 patients. Fifteen patients who were determined to have multi-organ metastasis including the adrenal glands were excluded, and the remaining 30 patients were reviewed.
The location of adrenal metastasis was right side, left side, and both in 17, 9, and 4 patients, respectively. Treatment for adrenal metastasis consisted of adrenalectomy in 5 patients, non-surgical treatment such as TACE, or chemotherapy and radiotherapy in 19 patients, while 6 patients received no treatment. The median survival duration was 11.05 months in the 30 patients with adrenal metastasis. In the 25 patients with well-controlled intrahepatic lesions, the median survival time of those patients who received adrenalectomy, non-surgical treatment, and no treatment was 21.41, 11.05, and 5.64 months, respectively. The difference in cumulative survival according to mode of treatment of adrenal metastasis in the well-controlled intrahepatic lesion group was statistically significant.
We envisage increased benefit after adrenalectomy in terms of survival in patients with well controlled intrahepatic lesions at the time of adrenal metastasis and good general medical condition.
本研究旨在分析每种治疗方式的效果，以明确肝细胞癌（HCC）肾上腺转移的治疗策略。
观察到45例HCC肾上腺转移患者。排除15例被确定有包括肾上腺在内的多器官转移患者，对其余30例患者进行回顾性分析。
肾上腺转移的部位分别为右侧17例、左侧9例、双侧4例。肾上腺转移的治疗包括5例行肾上腺切除术，19例行TACE等非手术治疗或化疗及放疗，6例未接受治疗。30例肾上腺转移患者的中位生存时间为11.05个月。在25例肝内病灶得到良好控制的患者中，接受肾上腺切除术、非手术治疗和未接受治疗的患者中位生存时间分别为21.41个月、11.05个月和5.64个月。肝内病灶良好控制组中，根据肾上腺转移治疗方式的累积生存率差异具有统计学意义。
我们设想，对于肾上腺转移时肝内病灶得到良好控制且一般身体状况良好的患者，肾上腺切除术后生存获益会增加。
