Iwanami Takashi, Uramoto Hidetaka, Baba Tetsuro, Takenaka Masaru, Yokoyama Erina, Oka Soichi, So Tetsuya, Ono Kenji, So Tomoko, Takenoyama Mitsuhiro, Hanagiri Takeshi, Iwata Teruo, Inoue Masaaki, Yasumoto Kosei
Department of Thoracic Surgery, Niigata Rosai Hospital, Joetsu, Japan.
Kyobu Geka. 2010 Dec;63(13):1101-6; discussion 1106-8.
To evaluate the optimum treatment strategy for metastatic adrenal tumors derived from non-small cell lung cancer (NSCLC), we retrospectively analyzed 17 consecutive cases (8 resection cases: 4 synchronous and 4 metachronous: 9 non-resection cases: 3 synchronous and 6 metachronous) who received surgical resection for NSCLC. The patients included 12 males and 5 females with a mean age of 63.9 years. Of these, 9, 3, 2, 2, and 1 patient (s) were diagnosed as having adenocarcinoma, squamous cell carcinoma, pleomorphic carcinoma, large cell carcinoma, and adenosquamous cell carcinoma, respectively. The mean interval after lung resection and treatment of metachronous adrenal metastasis was 9.9 months. The mean time to progression from treatment of metachronous adrenal metastasis to disease progression was 8.9 months. A survival analysis showed no significant prognostic difference between the patient age, gender, pathological stage, synchronous/metachronous classification, CEA, and site of metastases. However, patients who received an adrenalectomy had a more favorable prognosis. The 2-year survival of patients following resection versus those who did not undergo a resection for adrenal metastasis was 62.5 and 22.8%, respectively. These data indicate that metastatic adrenal tumors should be resected if the patient can tolerate surgery after appropriate selection.
为评估非小细胞肺癌（NSCLC）来源的转移性肾上腺肿瘤的最佳治疗策略，我们回顾性分析了17例连续接受NSCLC手术切除的患者（8例切除病例：4例同时性和4例异时性；9例未切除病例：3例同时性和6例异时性）。患者包括12例男性和5例女性，平均年龄63.9岁。其中，分别有9例、3例、2例、2例和1例患者被诊断为腺癌、鳞状细胞癌、多形性癌、大细胞癌和腺鳞癌。肺切除与异时性肾上腺转移治疗之间的平均间隔为9.9个月。从异时性肾上腺转移治疗到疾病进展的平均进展时间为8.9个月。生存分析显示，患者年龄、性别、病理分期、同时性/异时性分类、癌胚抗原（CEA）和转移部位之间无显著预后差异。然而，接受肾上腺切除术的患者预后更有利。肾上腺转移瘤切除术后患者与未接受切除术患者的2年生存率分别为62.5%和22.8%。这些数据表明，如果患者在经过适当选择后能够耐受手术，转移性肾上腺肿瘤应予以切除。
